Senior Manager/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, utilizati