As a member of the Healthcare and benefits consulting practice, you will work with healthcare payers, providers, pharmaceuticals, and federal/state/local government agencies on a wide variety of consulting and assurance services to help them evaluate, strategize, develop, and manage their product portfolios, pricing/financial reporting, funding requirements, risk quantification, provider reimbursement, data analytics, and compliance. You will provide actuarial related services to a wide range of companies, as well as assisting a large number of clients with specific issues that they may have.
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- Product development / pricing / rate filing
- Medicare strategy
- Medicare, Medicaid, and ACA compliance
- Vendor selection/implementation
- Vendor/plan performance reviews
- Actuarial valuation / financial reporting
- Medicare / commercial risk adjustment
- Other actuarial analysis and data analytics
- Postretirement programs/Medicare Part D
- Provider reimbursement redesign / contracting / risk sharing
- Enterprise Risk Management / risk assessment
Position/Program Requirements
Basic Qualifications:
Minimum Years of Experience: 8 years
Minimum Degree Required: Bachelor of Science or Bachelor of Arts degree
Minimum Degree Required Major: Actuarial Sciences, Mathematics, Statistics or Finance
Certification(s) Required: Associate of the Society of Actuaries, ASA, or Fellow of the Society of Actuaries, FSA, and MAAA
Degree(s) Preferred: Master’s Degree
Preferred Degree Major:
Actuarial Sciences, Mathematics, Statistics or Finance
Knowledge Preferred:
Demonstrates proven intimate levels of, and/or success in roles directing functions or projects involving, actuarial aspects of government programs—i.e. Medicare/Medicaid
and commercial markets and issues in a major consulting firm or corporate environment, emphasizing areas that include
health plan financial reporting, data analysis, pricing/underwriting, and compliance issues.
Skills Preferred:
Demonstrates proven intimate abilities and success in roles with interpreting, leveraging, and understanding the impact of the following as it relates to the healthcare and benefits-related consulting: Affordable Care Act, ACA, Medicare/Medicaid pricing, and financial reporting issues; Healthcare Analytics and its impact on risk adjustment and risk Management;
Demonstrates proven expert-level abilities and success in roles driving the identification and addressing of client needs: developing and sustaining deep client relationships using networking, negotiation and persuasion skills to identify and sell potential new service opportunities; preparing and presenting complex written and verbal materials; and defining resource requirements, project workflow, budgets, billing and collection.
Demonstrates thought leader-level abilities and success in roles serving as a functional or team leader: leading teams to generate a vision, establish direction and motivate members, create an atmosphere of trust, leverage diverse views, coach staff, and encourage improvement and innovation.
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