Subject Matter Expert - Senior Healthcare Actuarial SME

Harnessing Technology to Improve Financial Stewardship for the Welfare, Defense, and Security of Our Nation

Blake Willson Group (BWG) unites deep domain experts with technologists who leverage industry-leading financial management solutions to address the most critical mission objectives. Headquartered in the National Capital Region, the firm delivers measurable outcomes through technology-forward strategies and advanced solutions that drive mission success.

Blake Willson Group has a distinguished track record of exceptional performance, achieving operational efficiencies that allow our clients to do more with less. BWG has earned the confidence of its clients by consistently exceeding expectations through its unwavering commitment to best value solutions, implemented with speed.

Job Location:

This role is 100% remote.

Clearance:

Must be currently authorized to work in the United States on a full-time basis and have the ability to obtain a Public Trust Security Clearance.

Job Description:

Blake Willson Group is seeking an experienced Senior Healthcare Actuarial Subject Matter Expert (SME) to lead the actuarial evaluation of complex managed healthcare proposals supporting a major federal procurement valued at nearly $1 trillion. The role will evaluate actuarial methodologies, healthcare cost projections, utilization assumptions, trend factors, risk adjustments, rate development, and supporting data to identify deficiencies, risks, and areas requiring clarification or negotiation. The SME will develop actuarial findings for the Price Analysis Report, independently validate Offeror assumptions and models, and communicate the financial impact of actuarial findings to pricing specialists, acquisition personnel, and senior Government decision-makers. In this position, you will also:

• Lead actuarial analysis of complex medical and dental healthcare proposals valued at nearly $1 trillion.
• Review solicitation requirements, actuarial instructions, evaluation criteria, data specifications, amendments, and Government assumptions for compliance.
• Evaluate actuarial models, rate development methodologies, utilization, unit costs, trend factors, risk adjustments, population assumptions, and provider-network impacts.
• Assess the quality, completeness, credibility, and consistency of claims, encounter, eligibility, membership, provider, and utilization data.
• Analyze key actuarial assumptions, including IBNR, seasonality, benefit changes, population mix, geographic variation, reimbursement, network discounts, credibility, and normalization.
• Independently test material calculations, models, sensitivity analyses, and scenarios for mathematical and methodological accuracy.
• Benchmark Offeror assumptions and results against historical experience, independent estimates, Government assumptions, market data, and other available benchmarks.
• Identify methodological weaknesses, unsupported assumptions, data limitations, inconsistencies, uncertainty, and potential financial or performance risks.
• Develop clarification questions and negotiation recommendations, including supporting rationale and potential financial impact.
• Prepare Price Analysis Report sections, briefings, exhibits, and negotiation-support materials; update analyses through proposal revisions and negotiations while maintaining traceable workpapers, applying applicable actuarial standards, and protecting sensitive information.

Required Skills:

• Bachelor's degree in Finance, Economics, Mathematics, Actuarial Science, Statistics, Healthcare Administration, or a related field.
• 8+ years of experience in healthcare actuarial analysis, managed-care analytics, healthcare economics, rate development, or related work.
• 6+ years of experience developing, reviewing, or validating managed healthcare cost and utilization projections, including experience with utilization forecasting, medical trend, unit cost, provider reimbursement, risk adjustment, rate development, claims completion/IBNR, or experience studies.
• 6+ years of experience independently evaluating actuarial assumptions and complex models, with advanced Excel, strong technical-writing skills, and the ability to communicate actuarial findings and financial implications to non-actuarial stakeholders under compressed deadlines.

Desired Skills:

• Experience supporting federal or state healthcare procurements, proposal evaluations, rate reviews, or contract negotiations.
• Experience with Medicare, Medicaid, TRICARE, VA Community Care, Federal Employees Health Benefits, commercial managed care, or comparable large healthcare programs.
• Experience evaluating health-plan, third-party administrator, provider-network, medical, dental, or pharmacy proposals.
• Knowledge of applicable Actuarial Standards of Practice, particularly those addressing data quality, modeling, credibility, healthcare cost estimates, and communications.
• Experience using SQL, SAS, R, Python, Power Query, Power BI, or other actuarial and analytical tools.
• Experience preparing formal actuarial reports, proposal-evaluation findings, rate certifications, actuarial opinions, or negotiation-support analyses.

At Blake Willson Group, we believe in transparency and fairness in compensation practices. For this position, we offer a competitive salary range of $130,000 to $180,000 in the United States. Your individual salary within this range will be determined by various factors, including but not limited to your education, experience, skills, and geographic location. We also provide a comprehensive Total Rewards package, which includes major medical benefits such as dental and vision coverage, a 401(k)-contribution plan, holiday and personal time off, professional development training & certification benefits, health & wellness subsidies, paid time off for community service, and more. We value your contributions and are committed to recognizing and rewarding your performance and the value you bring to our business.

The statements above describe the general nature and level of work anticipated for this role. They are not intended to be an exhaustive list of all duties, responsibilities, or skills required. Blake Willson Group reserves the right to modify, assign, or add job-related responsibilities as business needs require. Where feasible, reasonable accommodations may be provided for individuals to perform essential job functions.

Blake Willson Group is an Equal Employment Opportunity (EEO) employer and is committed to maintaining a professional, respectful, and harassment-free workplace. All employment decisions are based on business needs, qualifications, and merit. We comply with all applicable federal, state, and local employment laws and do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other legally protected status. Blake Willson Group prohibits unlawful discrimination, harassment, and retaliation.

Blake Willson Group complies with federal equal employment opportunity requirements. The “Know Your Rights: Workplace Discrimination Is Illegal” poster is available to applicants and employees. View the official poster here: Know Your Rights: Workplace discrimination is illegal

If you require a reasonable accommodation during the application process, please contact us at View phone number on aiapply.co.

Blake Willson Group participates in E-Verify to confirm employment eligibility and will provide the federal government with your Form I-9 information to verify authorization to work in the United States.