Actuarial Consultant

Your Role

Join our dynamic Risk Adjustment Retrospective Analytics team, where you will play a crucial role in delivering precise analytics for chart review targeting, financial impact calculations, and data submission. As an Actuarial Consultant, you will report directly to the Manager of Risk Adjustment Retrospective Analytics. Your key responsibilities will include developing and fine-tuning chart targeting lists, quantifying the financial implications of our Retrospective program, and ensuring accurate data submission for Medicare Advantage and ACA Chart Review Programs.

Your Knowledge and Experience

• A bachelor's degree in mathematics, statistics, computer science, or a related field is required, with a minor in the mentioned subjects desirable.
• A minimum of 6 years of professional actuarial experience is necessary.
• Strong proficiency in MS Office applications, particularly Excel, Word, and PowerPoint, is essential.
• Demonstrated ability to create and validate analytic processes aligned with broader enterprise objectives.
• Preferred program management skills with a proven track record of diagnosing root causes of analytic challenges.
• Experience in finance (revenue and expense accounting), healthcare enrollment, claims processing, and general healthcare knowledge is required.
• Familiarity with the HHS-Developed Risk Adjustment Model Algorithm for the commercial market is preferred.
• Exceptional written and verbal communication skills, particularly in conveying technical material to executive leadership.
• Preferred : An ASA designation and completion of 1 to 2 courses towards FSA designation.