Lead Actuarial Consultant-Medicare MSSP & Medicare Advantage Bid

About the Role

The Actuary will serve as a subject matter expert leading actuarial analyses, financial modeling, and regulatory deliverables for Medicare Shared Savings Program (MSSP) and Medicare. Advantage (MA) clients. This senior individual contributor role is responsible for the full lifecycle of actuarial work—from data preparation and model development through assumption documentation and client presentation—while collaborating closely with Humbi.AI's consulting and data science teams to deliver differentiated analytical products. While day-to-day responsibilities do not typically include active Medicare Advantage bid development and filing, deep knowledge of the MA bid process and CMS requirements is essential for advising clients and informing analytical work.

A Day in the Life

• Design and execute actuarial financial analyses for MSSP Accountable Care Organization (ACO) clients, including benchmark development, savings calculations, and risk score trends.
• Lead rate development and rate review engagements for Medicare and other healthcare program clients, ensuring actuarial soundness and regulatory compliance.
• Build and maintain robust actuarial models for medical cost projections, utilization trend analysis, and PMPM rate development.
• Access, query, and analyze CMS Medicare claims data through the Chronic Conditions Warehouse Virtual Research Data Center (CCW VRDC) to support client analytics and population health studies.
• Collaborate with data engineers and data scientists to leverage Innovaccer's health data platform for enhanced analytics capabilities.
• Serve as actuarial lead on client engagements, presenting findings and recommendations to health plan and provider organization leadership.
• Ensure all work products comply with applicable CMS regulations, Actuarial Standards of Practice (ASOPs), and the Actuarial Code of Professional Conduct.
• Mentor senior actuarial analysts and review their work products for technical accuracy and compliance.
• Contribute to the development of new actuarial service offerings and internal intellectual property.
• Support business development activities including proposal writing, client presentations, and thought leadership content.

What You Need

• ASA designation preferred
• Minimum 6+ years of actuarial experience in healthcare, with significant Medicare-focused work.
• Strong working knowledge of MSSP program mechanics, benchmark methodology, risk score adjustment, and ACO financial reconciliation.
• Experience with rate development and/or rate review processes for Medicare or other government healthcare programs.
• Proficiency in actuarial modeling tools and data analysis platforms (SAS, SQL, R, Python, or equivalent).
• Strong written and verbal communication skills with demonstrated ability to present complex analyses to non-technical stakeholders.
• Experience working in a consulting, health plan, or managed care actuarial environment.

Preferred Qualifications

• Experience with Medicare Advantage bid development and familiarity with CMS bid submission requirements.
• Hands-on experience accessing and analyzing CMS data through the CCW Virtual Research Data Center (VRDC).
• Experience with Medicaid or commercial ACA risk adjustment in addition to Medicare.
• Familiarity with value-based care contracting models including capitation, shared savings, and bundled payments.
• Experience contributing to health analytics product development in partnership with technology teams.
• Prior consulting experience with ACOs, IDNs, or CMS Innovation Center models.

We offer competitive benefits to set you up for success in and outside of work.

Here’s What We Offer

• Generous Paid Time Off: Recharge and relax with 22 days of fixed time off per year, in addition to company holidays—because we believe work-life balance fuels performance.
• Best-in-Class Parental Leave: Spend quality time with your growing family. We offer one of the industry’s most generous parental leave policies to support you during life’s most important moments.
• Recognition & Rewards: We celebrate wins—big and small. Get rewarded with monetary incentives and company-wide recognition for your impact and dedication. Your hard work won’t go unnoticed.
• Comprehensive Insurance Coverage: Stay covered with medical, dental, and vision insurance, plus 100% company-paid short- and long-term disability and basic life insurance. Optional perks include discounted legal aid and pet insurance.

Innovaccer Inc. is an equal opportunity employer. We celebrate diversity and are committed to fostering an inclusive workplace where all employees feel valued and empowered regardless of any characteristic protected by federal, state or local law including, without limitation, race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, medical condition, disability, age, marital status, or veteran status. Innovaccer Inc. participates in the E-Verify program to confirm employment eligibility of all newly hired employees based out of the U.S. and employed by Innovaccer Inc.

For any additional information, please visit the below websites:

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Disclaimer:

Innovaccer does not charge fees or require payment from individuals or agencies for securing employment with us. We do not guarantee job spots or engage in any financial transactions related to employment. If you encounter any posts or requests asking for payment or personal information, we strongly advise you to report them immediately to our HR department at [email protected]. Additionally, please exercise caution and verify the authenticity of any requests before disclosing personal and confidential information, including bank account details.