Health Actuarial Consultant - ASA or FSA - Evergreen
Mercer Government Human Services Consulting (GHSC) specializes in assisting government-sponsored programs in becoming more efficient purchasers of health and welfare services. Mercer GHSC brings a team of consultants, clinicians, actuaries, analysts, and accountants to a project to assure a coordinated approach to the administrative, operational, actuarial, and financial components of public-sponsored health and welfare programs.
The Government Actuarial Consultant will lead the accurate and timely data and financial analysis on large and complex state managed health and welfare capitation projects. The Government Actuarial Consultant will also to be the actuarial expert for projects and proposals, as well as the mentor for more junior actuarial staff and oversee their basic actuarial work. To fulfill this role, the Actuary will:
- Serve as lead or co-lead actuary on large and complex state managed health and welfare capitation projects. These capitation projects are commissioned by government entities to determine the rates that they will pay for health and welfare services covered by their plans.
- In conjunction with the project leader, work with the client to define the scope of the project. Serve as expert on rate structure and methodology. Ensure project consistent with federal regulations and actuarial standards. Determine the appropriate data sources for the specific project's data analysis.
- Provide actuarial oversight and guidance in developing the data model
- Develop the rate setting assumptions that are built into the data model and informs client and project team on impact of data assumptions. Oversee data analysis that is conducted by junior staff members. Provide on-going review and guidance during the data analysis process. Review data analysis results for actuarial soundness. Present client with sub analyses throughout project cycle.
- Collaborate with client team and project team to finalize rates. Educate client on the impact of their policies on the data and rates.
- Draft project communications, including rate capitation letters. Act as actuarial authority that signs and certifies rate capitation letters.
- Present results and analysis to clients and key stakeholders. During presentations, answer detailed and challenging questions regarding the data
- Serve as either an actuarial project lead or lead project manager.
- Ensure project scope clearly defined, timelines clearly established, work allocated to staff members, project documents are completed and correct, keep project and client teams informed
- May direct the work of employees in a team and/or coach/mentor others
- Participate in request for proposal (RFP) process. Define approach to projects, methodology of data modeling and preliminary scope of actuarial work required to complete project. Draft proposals defining suggested methodologies and estimated scope of work for RFPs.
- Stay current on Health Policy environment and consider the implication of policy, law, political, etc. changes impact client and client's programs
- Develop intellectual capital, which may include policy discussion with others, design of new data model or tool, or research
Meet Some of Marsh & McLennan Companies's Employees
Contract Review Specialist
Nancy reviews the contracts her clients either offer or receive from vendors, taking care to monitor the insurance requirements on the provided services.
Back to top