Healthcare Consulting Actuary – Provider & Value-Based Care (FSA)

Description

Millimans Mountain Gulf Health Practice is seeking a Healthcare Actuary to work full-time with provider clients. Youd be supporting health systems physician groups and ACO enablers who are taking on risk under various value-based payment models.

You need to be technically strong and have sound judgment about which analysis answers the question client leadership is asking then explain it in a way that is clear and supports decision making. You will also need to be self-directed. We provide extensive on-the-job training in consulting skills and advanced actuarial techniques.

Who We Are

Independent for over 75 years Milliman delivers market-leading services and solutions to clients worldwide. Today we are helping companies take on some of the worlds most critical and complex issues including retirement funding and healthcare financing risk management and regulatory compliance data analytics and business transformation.

Milliman invests in skills training and career development and gives all employees access to a variety of learning and mentoring opportunities. Our growing number of Milliman Employee Resource Groups (ERGs) are employee-led communities that influence policy decisions develop future leaders and amplify the voices of their constituents. We encourage our employees to give back to their varied professions including leadership in professional organizations. Please visit our web site ( to learn more about Millimans commitments to our people inclusion and sustainability.

Through a team of professionals ranging from actuaries to clinicians technology specialists to plan administrators we offer unparalleled expertise in employee benefits investment consulting healthcare life insurance and financial services and property and casualty insurance.

What You Will Do

In this role you will:

• Model provider performance under MSSP ACO REACH and LEAD. That means benchmark projection attribution risk score dynamics savings and loss estimation and scenario testing across risk tracks.
• Evaluate value-based contracts from the provider side: shared savings and downside risk global and primary care capitation episode and bundled payments and how risk and reward get distributed downstream.
• Model reimbursement and support rate negotiations with payers.
• Dig into claims enrollment and CMS data to answer questions about utilization cost drivers risk adjustment and network performance.
• Run projects. Scoping budgets delegating technical work to analysts and students holding timelines talking to clients directly.
• Draft the client-facing material: emails memos decks and reports written for CFOs and medical group leadership.
• Help write proposals alongside a senior consultant.
• Support other types of clients and projects in the practice as needed.

As careers grow at Milliman consultants take on their own client relationships and lead business development. That is not the initial focus of this role but it is a natural next step and we will support you toward it.

What We Are Looking For

Professional Qualifications

• Bachelors degree in actuarial science math statistics economics or something similarly quantitative
• FSA designation
• Five to eight years in healthcare actuarial work with a solid understanding of provider perspectives
• Hands-on knowledge of at least one CMS or CMMI total cost of care program (MSSP ACO REACH Primary Care First a bundled payment model).
• Experience building benchmarks for CMS/CMMI programs and/or other risk-based arrangements
• Experience with attribution methodologies
• Familiarity with provider reimbursement: fee schedules capitation case rates episode payments
• Excel expertise
• Experience managing projects: scoping budget delegation timelines client contact
• Ability to explain technical work to people who are not technical
• Solid understanding of the US healthcare system
• Experience working with detailed healthcare claims data
• SQL Python R or SAS

Personal Qualifications

• Proactive and can anticipate what the analysis needs and what the client will ask next.
• Makes decisions and able to move work forward independently while completing appropriate reviews with senior consultants
• Clear writer and speaker
• Works well alone and on teams
• Steady in a fast-paced environment where client satisfaction is key
• Entrepreneurial

Preferred Qualifications

• Experience with CMS claim and claim line feed (CCLF) data
• Experience modeling participation decisions across CMS and CMMI programs
• Experience supporting payer contract negotiations
• Experience drafting proposals or client reports

Individuals must be legally authorized to work in the United States without the need for immigration support or sponsorship from Milliman now or in the future.

The Team

Mountain Gulf Health serves healthcare providers health plans state and federal agencies insurers reinsurers and employers. The practice includes over 50 actuarial professionals along with healthcare consultants administrative staff and other non-actuarial personnel.

Our provider work covers CMS and CMMI program participation value-based contract evaluation capitation and bundled payment design and payer contracting support. Clients range from large health systems to independent physician groups to ACO enablement companies. Provider work continues to grow and this role adds to that team. You will have access to Millimans healthcare data assets and modeling tools for client work. No prior experience with them is expected.

You will be working with some of the most experienced people in the health industry. Our manager program pairs you with a colleague to help guide your career growth.

Location

This is a remote position. Candidates hired into this role may work onsite in select Milliman office locations if they prefer. The expected application deadline for this job is December 31 2026.

Compensation

The overall salary range for this role is $103500 - $214820. For candidates residing in:

• Alaska California Connecticut Illinois Maryland Massachusetts New JerseyNew York CityPennsylvania Virginia Washington or the District of Columbia the range is $.

• All other locations the range is $103500 - $186800.

A combination of factors will be considered including but not limited to education relevant work experience qualifications skills certifications etc.

Employees are also eligible for a bonus under our standard bonus policy. A paid bonus is dependent on billable hours worked by and work managed by the employee. Actual bonuses vary widely based on desired and completed workload but routinely exceed 25% of base salary.

To be considered for this position please upload a resume and cover letter.

No recruiters please.

Benefits

We offer a comprehensive benefits package designed to support employees health financial security and well-being. Benefits include:

• Medical Dental and Vision Coverage for employees dependents and domestic partners.
• Employee Assistance Program (EAP) Confidential support for personal and work-related challenges.
• 401(k) Plan Includes a company matching program and profit-sharing contributions.
• Discretionary Bonus Program Recognizing employee contributions.
• Flexible Spending Accounts (FSA) Pre-tax savings for dependent care transportation and eligible medical expenses.
• Paid Time Off (PTO) Begins accruing on the first day of work. Full-time employees accrue 15 days per year and employees working less than full-time accrue PTO on a prorated basis.
• Holidays A minimum of 10 paid holidays per year.
• Family Building Benefits Includes adoption and fertility assistance.
• Paid Parental Leave Up to 11 weeks of paid leave for employees who meet eligibility criteria.
• Life Insurance & AD&D 100% of premiums covered by Milliman.
• Short-Term and Long-Term Disability Fully paid by Milliman.

Equal Opportunity

All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation national origin disability or status as a protected veteran.

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