Senior Consulting Actuary

Overview

BerryDunn’s Health Analytics Practice Group (HAPG) is dedicated to supporting decision-makers in state government healthcare agencies, mission-driven organizations, and other public and private sector organizations. Our team brings together deep expertise in actuarial science, health economics, data science, policy analysis, healthcare financing, and advanced analytics to help clients address complex questions involving healthcare financing and payment, cost and risk, program performance, and the use of data analytics to inform policy, operational, and strategic decisions.

As a Senior Consulting Actuary, you will apply actuarial expertise, healthcare financing knowledge, quantitative methods, and consulting judgment to real-world challenges facing Medicaid programs, public-sector healthcare agencies, and the populations they serve. Your work may span public and private policy and financing, healthcare payment and reimbursement, program evaluation, healthcare cost projections, risk adjustment, fiscal impact analysis, financial modeling, healthcare affordability, and other emerging healthcare policy priorities.

The position will include significant work supporting Hawaiʻi Med-QUEST, applying actuarial and quantitative methods to Medicaid policy, healthcare financing, healthcare spending, provider reimbursement, payment transformation initiatives, and program performance improvement efforts. You will work closely with health economists, Medicaid policy experts, data scientists, healthcare analysts, provider finance specialists, and other professionals to evaluate policy options, assess financial and operational impacts, and translate complex analyses into practical recommendations for healthcare decision-makers.

This position offers the opportunity to work on high-impact projects such as:

• Evaluating how Medicaid eligibility, enrollment, coverage continuity, work or community engagement requirements, and other federal or state policy changes may affect utilization, access, spending, provider reimbursement, managed care payments, beneficiaries, and program operations.
• Developing forecasts, scenarios, actuarial models, fiscal impact analyses, and financial projections to inform Medicaid policy design, implementation planning, monitoring, and evaluation.
• Assessing the fiscal, utilization, provider, beneficiary, and operational impacts of Medicaid policy, financing, reimbursement, and program design initiatives.
• Analyzing healthcare financing and payment approaches, including Medicaid managed care capitation, provider reimbursement, value-based and alternative payment models, Total Cost of Care frameworks, multi-payer approaches, and other payment transformation initiatives.
• Supporting Medicaid financing, waiver, state plan, directed payment, provider reimbursement, budget neutrality, cost-effectiveness, and fiscal modeling analyses.
• Designing evaluation and performance-monitoring approaches that help Medicaid leaders assess program outcomes and make evidence-based policy, financing, and implementation decisions.

This position offers flexibility in work location, including fully onsite, hybrid, or remote arrangements. The preferred location is Hawaiʻi or the U.S. West Coast, although other locations may be considered based on business needs and candidate qualifications. BerryDunn’s Hawaiʻi office is located in Kapolei, Oʻahu.

The role requires availability during Hawaii Standard Time working hours and may require periodic travel within Hawaiʻi, the Pacific region, and the continental United States based on project and client needs.

Travel expectations forthis role are dependent upon client needs but are expected to be less than 25% per year.

You Will

• Design and conduct actuarial, financial, and quantitative analyses addressing Medicaid policy, eligibility, enrollment, coverage continuity, utilization, access, spending, provider reimbursement, managed care payments, incentives, program performance, and operational impacts.
• Assess the potential effects of federal and state Medicaid policy changes, including work and community engagement requirements, on beneficiaries, providers, managed care organizations, program administration, and State expenditures. Develop scenarios and analytic approaches to support implementation planning, monitoring, and evaluation.
• Develop actuarial models, forecasts, fiscal impact analyses, scenario analyses, cost projections, and other quantitative approaches using Medicaid claims, encounter, eligibility, enrollment, provider, financial, demographic, and operational data. Clearly document methods, assumptions, limitations, uncertainty, and implications for policy and implementation.
• Analyze healthcare financing and payment approaches, including Medicaid managed care capitation rates, provider reimbursement methodologies, value-based and alternative payment models, Total Cost of Care initiatives, healthcare spending growth, supplemental payments, directed payments, and multi-payer reform efforts.
• Apply actuarial and financial methods to evaluate healthcare spending trends, program performance, reimbursement strategies, financing alternatives, and policy initiatives. Assess fiscal impacts, implementation considerations, opportunities for improved efficiency, and potential unintended consequences.
• Support Medicaid financing and federal authority activities, including analyses related to 1915(b), 1915(c), and 1115 waivers; state plan amendments; directed payments; provider reimbursement; supplemental payment programs; public-provider financing; budget neutrality; cost-effectiveness; federal claiming strategies; and other healthcare financing mechanisms.
• Develop, review, or support actuarially sound healthcare payment and financing methodologies, including managed care capitation rates, risk adjustment, risk scoring, trend development, rate rebalancing, financial settlements, and related actuarial documentation.
• Structure complex client questions, develop analytic approaches and work plans, lead substantive actuarial and quantitative workstreams, oversee analytical quality, and engage directly with senior Medicaid, government, and healthcare leaders.
• Translate complex actuarial and financial findings into clear reports, presentations, policy briefs, technical documentation, and practical recommendations for technical and non-technical audiences.
• Collaborate across disciplines, including health economics, actuarial science, Medicaid policy, provider finance, data science, healthcare analytics, and operations.
• Mentor junior actuarial and analytic staff and contribute to proposals, new client opportunities, client relationship development, business development, and the continued growth of BerryDunn’s Medicaid, actuarial, and healthcare consulting services.

You Have

Minimum Qualifications

• Associate or Fellow of the Society of Actuaries with active membership in the American Academy of Actuaries.
• Annual attestation to meeting the U.S. Qualification Standards, including applicable Specific Qualification Standards for the actuarial work performed.
• At least 15 years of relevant health actuarial experience, including substantial experience supporting Medicaid programs, public-sector healthcare initiatives, managed care organizations, health insurance programs, healthcare financing analyses, or healthcare consulting clients.
• Demonstrated experience applying actuarial methods to real-world healthcare questions, including healthcare cost projections, fiscal impact analyses, payment modeling, risk adjustment, managed care financing, provider reimbursement, program evaluation, or related quantitative analyses.
• Strong knowledge of Medicaid policy, healthcare financing, managed care, provider payment, reimbursement, actuarial standards of practice, CMS requirements, and federal and state healthcare regulations.
• Demonstrated experience analyzing healthcare claims, encounter, eligibility, enrollment, utilization, provider, financial, demographic, or related data and translating actuarial findings into meaningful financial, policy, program, and operational implications.
• Demonstrated ability to independently lead complex actuarial or quantitative work, exercise sound professional and methodological judgment, oversee the work of actuaries, analysts, or other technical staff, and collaborate effectively across multidisciplinary teams.
• Excellent written, verbal, and presentation skills, including the ability to explain complex actuarial methods, findings, assumptions, uncertainty, limitations, and policy implications clearly to technical and non-technical audiences.
• Strong client relationship, project management, and leadership skills, including the ability to manage competing priorities, produce high-quality deliverables, and build trust with clients and colleagues.
• Advanced proficiency with Microsoft Excel, Word, and PowerPoint.
• Ability to work appropriately with sensitive Medicaid, provider, and beneficiary data, including personally identifiable information and protected health information, and follow applicable privacy, security, confidentiality, and HIPAA requirements.

Preferred Qualifications

• Experience supporting state or territorial Medicaid agencies, CMS initiatives, Medicaid managed care programs, nonprofit managed care organizations, accountable care organizations, large employer groups, or other publicly financed healthcare programs.
• Experience with Medicaid financing, federal-state or territorial financing arrangements, waiver analyses, state plan amendments, directed payments, provider reimbursement methodologies, supplemental or public-provider financing, federal claiming strategies, budget neutrality, cost-effectiveness, or fiscal modeling of healthcare financing alternatives.
• Experience developing, reviewing, certifying, or supporting actuarially sound Medicaid managed care capitation rates, including experience with CMS rate certification requirements and review processes.
• Experience with risk adjustment, risk scoring, encounter data analytics, rate rebalancing, risk-adjusted settlements, claims liability analysis, trend development, financial forecasting, healthcare cost projection modeling, or managed care payment methodologies.
• Experience with provider payment and reimbursement, value-based or alternative payment models, Total Cost of Care, hospital or primary care payment models, healthcare spending and affordability initiatives, multi-payer reform efforts, or other payment transformation activities.
• Experience evaluating Medicaid eligibility, enrollment, coverage continuity, beneficiary behavior, or the effects of federal and state healthcare policy changes.
• Experience with HCBS, LTSS, PACE, behavioral health, mandated benefit reviews, healthcare affordability analyses, or other public-sector healthcare policy and financing initiatives.
• Experience supporting program integrity, payment integrity, compliance monitoring, or related financial and operational analyses.
• Experience in consulting or another client-facing environment, including managing client relationships, mentoring junior professionals, and contributing to proposal development and business development activities.

The ideal candidate will be a senior health actuary who combines actuarial rigor with practical judgment and a deep interest in Medicaid policy, healthcare financing, healthcare payment, healthcare affordability, payment transformation, and program performance.

They should be comfortable moving between detailed actuarial analysis and broader questions about how eligibility policies, payment arrangements, financing decisions, reimbursement methodologies, and implementation strategies affect healthcare spending, access, provider behavior, managed care organizations, beneficiaries, and State operations.

They should be intellectually curious, able to work effectively with complex or imperfect data and evolving federal and state policy environments, and willing to challenge assumptions, identify tradeoffs and unintended consequences, and clearly distinguish what the evidence can and cannot support.

The successful candidate will also be an effective leader and collaborator who works well across actuarial, economic, policy, provider finance, data science, healthcare analytics, and operational teams; builds trusted relationships with clients and colleagues; supports the growth of junior staff; and translates sophisticated actuarial and financial analysis into practical recommendations that strengthen healthcare financing, payment, policy, and program performance.

Compensation Details

The base salary range targeted for this role is $200,000 - $275,000. This salary range represents BerryDunn’s good faith and reasonable estimate of the range of possible compensation at the time of posting. If an applicant possesses experience, education, or other qualifications more than the minimum requirements for this posting, that applicant is encouraged to apply, and a final salary range may then be based on those additional qualifications; compensation decisions are dependent on the facts and circumstances of each case. The salary of the finalist selected for this role will be based on a variety of factors, including but not limited to, years of experience, depth of experience, seniority, merit, education, training, amount of travel, and other relevant business considerations.

BerryDunn Benefits & Culture

Our people are what make BerryDunn special, and in return we strive to support our employees and help them thrive. Eligible employees have access to benefits that go beyond what’s expected to support their physical, mental, career, social, and financial well-being. Visit our website for a complete list of benefits and a look into our culture:Experience BerryDunn.

We will ensure that individuals are provided reasonable accommodation to participate in the job application or interview process or perform essential job functions. Please View email address on click.appcast.io request an accommodation.

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace.

About BerryDunn

BerryDunn is the brand name under which Berry, Dunn, McNeil & Parker, LLC and BDMP Assurance, LLP, independently owned entities, provide services. Since 1974, BerryDunn has helped businesses, nonprofits, and government agencies throughout the US and its territories solve their greatest challenges. The firm’s tax, advisory, and consulting services are provided by Berry, Dunn, McNeil & Parker, LLC, and its attest services are provided by BDMP Assurance, LLP, a licensed CPA firm.

BerryDunn is a client-centered, people-first professional services firm with a mission to empower the meaningful growth of our people, clients, and communities. Led by CEO Sarah Belliveau, the firm has been recognized for its efforts in creating a diverse and inclusive workplace culture, and for its focus on learning, development, and well-being. Learn more atberrydunn.com.

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