Senior Consulting Actuary

🕒 August 4

🇺🇸 United States – Remote

💵 $200k - $275k / year

⏰ Full Time

🟠 Senior

📊 Actuary

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BerryDunn — Assurance, Tax and Consulting

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1974

🏥 Healthcare

🛡️ Insurance

⚖️ Legal

Healthcare • Insurance • Legal

BerryDunn is an award-winning accounting and consulting firm with a 50-year history dedicated to providing exceptional services in assurance, tax, and consulting. The firm focuses on forming close partnerships with clients to deliver customized solutions that drive meaningful outcomes. Its expert teams work across various sectors, helping public and private entities optimize finances, reduce risks, and improve business processes with a commitment to client success.

📋 Description

• Lead actuarial engagements for state Medicaid agencies and other public health clients • Design and oversee encounter data analytics, validating completeness and accuracy • Produce utilization trend analyses and reconcile encounter data to financial data for managed care oversight • Develop and certify actuarially sound Medicaid managed care capitation rates, including risk adjustment methodologies • Develop and apply risk scoring methodologies for capitation rate rebalancing, individual risk scores, and risk-adjusted settlements • Conduct financial analyses and modeling for HCBS, LTSS, and PACE programs • Provide strategic guidance on program design, waiver development and submission support, and value-based payment models • Support federal authority activities, including cost-effectiveness and budget-neutrality analyses for waivers, state plan amendments, directed payments, and provider tax programs • Conduct fiscal and policy impact analyses, including rate modifications, hospital rebasing, UPL/GME payments, and pay-for-performance calculations • Collaborate with underwriters, policy experts, data analysts, health economists, and clinical consultants • Present complex actuarial findings to clients, stakeholders, and regulatory bodies • Mentor junior actuarial staff and contribute to professional development initiatives • Stay current with federal and state regulations, CMS guidance, and emerging commercial and public health trends

🎯 Requirements

• FSA or ASA with active membership in the American Academy of Actuaries (required) • 15+ years of health actuarial experience • At least 5 years supporting or employed by a state Medicaid agency • Demonstrated ability to lead a team of actuaries • Experience developing actuarially sound managed care capitation rates • Experience with risk adjustment methodologies and waiver cost-effectiveness models • Deep familiarity with CMS review processes, federal regulatory standards, and ASOP compliance • Expertise with Medicaid and commercial claims/encounter data, including APCDs and MMIS • Excellent communication skills and a strong record of producing defensible actuarial documentation • Executive presence and strong client relation skills • Ability to work in a collaborative environment • Advanced skills in Microsoft Excel, Word, and PowerPoint • Experience providing expert testimony or support in rate hearings and rate negotiations preferred • Desire to generate new business strongly preferred

🏖️ Benefits

• Benefits supporting physical, mental, career, social, and financial well-being • Potential for growth and advancement • Professional development initiatives • Minimal travel, less than 20% per year • Reasonable accommodation for the job application, interview process, or essential job functions