Healthcare Consulting Actuary – Provider & Value-Based Care, FSA

🔥 15 hours ago

🐻 Alaska, California, +9 more states – Remote

🐻 Alaska – Remote 🏄 California – Remote 🦌 Connecticut – Remote 🌽 Illinois – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🔔 Pennsylvania – Remote ⚔️ Virginia – Remote ☕ Washington – Remote

💵 $103.5k - $214.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📊 Actuary

🦅 H1B Visa Sponsor

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👻 Ghost score 0%

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Milliman

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1947

🏥 Healthcare

🛡️ Insurance

💼 Consulting

Healthcare • Insurance • Consulting

Milliman is an independent global actuarial and consulting firm founded in 1947 that provides expertise in insurance, healthcare, retirement and employee benefits, risk management, and related financial services. The firm combines actuarial rigor, data science, and technology to deliver consulting, modeling, software, and advisory solutions to public- and private-sector clients addressing challenges such as healthcare costs, market volatility, climate risk, and program design. Milliman operates worldwide with multidisciplinary teams including actuaries, data scientists, clinicians, and software engineers.

📋 Description

• Model provider performance under MSSP, ACO REACH, and LEAD, including benchmark projection, attribution, risk score dynamics, savings and loss estimation, and scenario testing across risk tracks • Evaluate value-based contracts from the provider side, including shared savings and downside risk, global and primary care capitation, episode and bundled payments, and downstream risk/reward distribution • Model reimbursement and support rate negotiations with payers • Analyze claims, enrollment, and CMS data to answer questions about utilization, cost drivers, risk adjustment, and network performance • Run projects, including scoping, budgeting, delegating technical work, managing timelines, and communicating directly with clients • Draft client-facing emails, memos, presentations, and reports for CFOs and medical group leadership • Help write proposals with a senior consultant • Support other clients and projects in the practice as needed • Progress toward managing client relationships and leading business development as career development opportunities

🎯 Requirements

• Bachelor's degree in actuarial science, math, statistics, economics, or a similarly quantitative field • FSA designation • Five to eight years in healthcare actuarial work • Solid understanding of provider perspectives • Hands-on knowledge of at least one CMS or CMMI total cost of care program, such as MSSP, ACO REACH, Primary Care First, or a bundled payment model • Experience building benchmarks for CMS/CMMI programs and/or other risk-based arrangements • Experience with attribution methodologies • Familiarity with provider reimbursement, including fee schedules, capitation, case rates, and episode payments • Excel expertise • Experience managing projects, including scoping, budgets, delegation, timelines, and client contact • Ability to explain technical work to non-technical audiences • Solid understanding of the US healthcare system • Experience working with detailed healthcare claims data • SQL, Python, R, or SAS • Proactive, independent, and able to anticipate analytical and client needs • Clear writing and speaking skills • Ability to work independently and on teams • Ability to work in a fast-paced, client-focused environment • Entrepreneurial mindset • Preferred: Experience with CMS claim and claim line feed (CCLF) data • Preferred: Experience modeling participation decisions across CMS and CMMI programs • Preferred: Experience supporting payer contract negotiations • Preferred: Experience drafting proposals or client reports • Must be legally authorized to work in the United States without immigration support or sponsorship from Milliman now or in the future • Resume and cover letter required

🏖️ Benefits

• Medical, Dental and Vision coverage for employees, dependents, and domestic partners • Employee Assistance Program (EAP) • 401(k) Plan with company matching and profit-sharing contributions • Discretionary Bonus Program • Flexible Spending Accounts (FSA) for dependent care, transportation, and eligible medical expenses • Paid Time Off (PTO); full-time employees accrue 15 days per year • Minimum of 10 paid holidays per year • Adoption and fertility assistance • Up to 11 weeks of paid parental leave for eligible employees • Life Insurance & AD&D; 100% of premiums covered by Milliman • Short-Term and Long-Term Disability; fully paid by Milliman • Extensive on-the-job training in consulting skills and advanced actuarial techniques • Skills training, career development, learning and mentoring opportunities • Employee Resource Groups (ERGs) • Manager program for career growth guidance • Access to Milliman healthcare data assets and modeling tools