Healthcare Consulting Actuary – Provider & Value-Based Care (FSA)
New
J
JobgetherHealthcare Consulting
Based in the United StatesFull-TimeSenior
SalaryBase salary ranging from $103,500 to $214,820, depending on location, experience, qualifications, skills, and certifications.
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Job Details
- Experience
- 5–8 years
- Required Skills
- Project ManagementPythonSQLMicrosoft ExcelR
Requirements
- Bachelor’s degree in actuarial science, mathematics, statistics, economics, or another quantitative discipline.
- Fellowship in the Society of Actuaries (FSA) or equivalent professional actuarial designation.
- 5–8 years of healthcare actuarial experience, including understanding of provider perspectives.
- Hands-on experience with at least one CMS or CMMI total cost-of-care program (e.g., MSSP, ACO REACH, Primary Care First).
- Experience developing benchmarks for risk-based healthcare arrangements and attribution methodologies.
- Knowledge of provider reimbursement models including capitation, case rates, and episode payments.
- Advanced Excel skills and experience working with detailed healthcare claims data.
- Experience with analytical tools such as SQL, Python, R, or SAS.
- Demonstrated project management experience including scoping, budgeting, and delegation.
- Strong written and verbal communication skills with the ability to explain complex concepts to non-technical audiences.
- Ability to work effectively both independently and collaboratively.
Responsibilities
- Model provider performance across CMS and CMMI programs including MSSP, ACO REACH, and LEAD.
- Evaluate value-based contracts including shared savings, downside risk, capitation, and bundled payments.
- Model provider reimbursement arrangements and support payer contract negotiations.
- Analyze detailed claims, enrollment, and healthcare data to identify cost drivers and risk-adjustment dynamics.
- Lead consulting projects by defining scope, managing budgets, delegating technical work, and coordinating deliverables.
- Develop client-facing deliverables including presentations, reports, and memoranda for leadership.
- Support proposal development and contribute to broader healthcare consulting engagements.
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