Senior Health Actuary

Job Title: Senior Consulting Actuary

Job Details:
Client 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.
 
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.