Medicaid Actuarial Senior Manager

This role is for a Medicaid Actuarial Senior Manager at Deloitte, focusing on providing strategic and technical consulting services to public sector clients. The responsibilities include leading engagements on Medicaid reimbursement, actuarial rate development, policy, budget forecasting, and fiscal analyses. A key aspect involves participating in the transformation of the healthcare sector through innovative actuarial solutions, including AI-driven solutions, and developing frameworks for value-based payment models. The role requires significant experience in health actuarial services, Medicaid managed care, and team leadership.

What you'd actually do

  1. Provide strategic and technical consulting services to public sector clients
  2. Lead engagements focused on Medicaid reimbursement, including actuarial rate development across managed care and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk adjustment
  3. Lead and manage end-to-end business development efforts for Federal and State governments, employer groups, and other public entities, including proposal development and capture
  4. Participate in the transformation of the health care sector through innovative actuarial solutions, such as AI-driven solutions, development of frameworks inclusive of social drivers of health, and transition of payment models to value-based payment frameworks
  5. Address complex, ill-defined problems with strong technical and innovative approaches

Skills

Required

  • Bachelor’s Degree
  • 15+ years of health actuary experience and consulting and/or health plan/insurance company experience
  • 8+ years of experience with Medicaid managed care capitation rate development and/or fee-for-service rate development
  • 5+ years of experience managing and leading teams
  • ASA with progression to FSA or FSA
  • Ability to travel up to 25%

Nice to have

  • Prior business development experience, preferably for state/local government clients
  • Experience providing Medicaid consulting services to Government agencies
  • Experience with Medicaid waivers (i.e., 1115, 1915 b/c, 1332)
  • Experience with risk adjustment mechanisms
  • Experience with Provider reimbursement streams (i.e., DSH, UPL, etc.)
  • Experience with health care reform and working knowledge of the individual medical and small group markets
  • Experience with Medicare products, including Medicare Advantage or Medicare Supplement products for various enrollee types
  • Familiarity with group insurance products including disability, long term care, etc.
  • Experience with product design and/or product strategy
  • Experience with reimbursement models – including value based care/ACO modeling
  • Successful marketing ability in selling services to prospects and existing clients
  • Experience understanding trends in the marketplace
  • Ability to work in a team environment sharing ideas and working collaboratively
  • Excellent interpersonal and written/verbal communication skills
  • Ability to work independently and in a team environment

What the JD emphasized

  • Medicaid reimbursement
  • actuarial rate development
  • Medicaid managed care capitation rate development
  • fee-for-service rate development
  • AI-driven solutions