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

Milliman, Inc; Denver (CO); Remote; USD 104,000 - 187,000; Full time

Benefits offered by this job

Medical, Dental & Vision

401(k) Plan

Discretionary Bonus

Paid Time Off

Job summary

Milliman, Inc. is seeking a Healthcare Actuary for Mountain Gulf Health Practice to support provider clients with risk-based models and value-based contracts.

You will analyze CMS data, project benchmarks, and lead client communications while working in a fully remote capacity with potential onsite options. The role requires strong actuarial expertise, 5–8 years in healthcare actuarial work, and familiarity with CMS/CMMI programs.

Qualifications

• Bachelor's degree in actuarial science, math, statistics, economics, or a similarly quantitative field.
• FSA designation.
• 5–8 years in healthcare actuarial work with provider perspective.
• Hands-on knowledge of at least one CMS or CMMI total cost of care program (MSSP, ACO REACH, Primary Care First, etc.).
• Experience building benchmarks for CMS/CMMI programs 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, budgeting, delegation, timelines, client contact.
• Ability to explain technical work to non-technical audiences.
• Solid understanding of the US healthcare system.
• Experience working with detailed healthcare claims data.
• SQL, Python, R, or SAS.

Responsibilities

• Model provider performance under MSSP, ACO REACH, and LEAD with benchmark projection, attribution, risk score dynamics, and scenario testing.
• Evaluate value-based contracts from the provider side and how risk/reward is distributed.
• Model reimbursement and support rate negotiations with payers.
• Analyze claims, enrollment, and CMS data to answer questions on utilization and cost drivers.
• Lead projects: scoping, budgeting, timelines, and client communication.
• Draft client-facing material: emails, memos, decks for CFOs and medical leadership.
• Assist in proposals and support other projects in the practice.

Skills

Excel expertise

Project management

Technical explanation

SQL, Python, R, SAS

Education

Bachelor's degree in actuarial science or quantitative field

FSA designation

Tools

CMS/CMMI benchmarks & risk models

Job description

Description

Milliman's Mountain Gulf Health Practice is seeking a Healthcare Actuary to work full-time with provider clients. You'd 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 world's 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 (https://www.milliman.com/en/social-impact) to learn more about Milliman's 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

• Bachelor's 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 Milliman's 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 $103,500 - $214,820. For candidates residing in:

• Alaska, California, Connecticut, Illinois, Maryland, Massachusetts, New Jersey, New York City, Pennsylvania, Virginia, Washington, or the District of Columbia the range is $119,025 - 214,820.
• All other locations the range is $103,500 - $186,800.

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.

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.