Medicaid Rate Development Consultant - Senior Leader

Selby Jennings; United States; On-site; USD 140,000 - 210,000; Full time

Job summary

Selby Jennings is partnering with a leading healthcare consulting organization to fill a true Medicaid rate development role. You will work hands-on with data, analytics, and actuarial support to develop and evaluate managed care rates for state Medicaid agencies.

Serve as a technical and people leader, analyzing claims and cost data, forecasting, and presenting insights to leadership while mentoring junior consultants to advance into senior roles.

Qualifications

• 10+ years in Medicaid managed care rate development or related field.
• Experience developing, reviewing, or supporting capitation rates.
• Experience with state Medicaid agencies, consulting firms, or managed care plans.
• Prior leadership or mentorship experience is valued.

Responsibilities

• Analyze claims, encounter, utilization, and cost data to support Medicaid rate development.
• Evaluate medical cost trends, revenue adequacy, and financial performance for rate setting.
• Partner with actuaries and state Medicaid agencies on rate development and forecasting.
• Translate analytics into actionable recommendations for Medicaid leadership.
• Present results and insights to state agencies and stakeholders.
• Mentor junior consultants to build technical and client-facing skills.

Skills

Excel skills

Quantitative skills

Financial modeling

Leadership

Actuarial support

Job description

We're partnering with a leading healthcare consulting organization that works directly with state Medicaid agencies on some of the largest and most complex rate development projects in the country.

This is a true Medicaid rate development role - Not a Medicaid strategy, policy, operations, provider contracting, or reimbursement negotiation position. We're specifically looking for someone who has been hands-on in the data, analytics, financial modeling, and actuarial support that goes into developing and evaluating Medicaid managed care rates.

What you'll be doing:

• Analyze claims, encounter, utilization, and cost data to support Medicaid managed care rate development
• Evaluate medical cost trends, revenue adequacy, and financial performance to inform rate-setting methodologies
• Partner with actuaries and state Medicaid agencies on rate development, forecasting, and financing initiatives
• Translate complex analytical findings into actionable recommendations for Medicaid leadership
• Present results and insights to state agencies and other key stakeholders
• Mentor and develop junior consultants, helping them build the technical and client-facing skills needed to advance into more senior roles

What we're looking for:

• 10+ years of experience in Medicaid managed care rate development, actuarial support, or healthcare economics
• Direct experience developing, reviewing, or supporting capitation rates
• Strong quantitative, financial modeling, and Excel skills
• Experience working with state Medicaid agencies, consulting firms, actuarial organizations, or managed care plans
• Prior leadership or mentorship experience is highly valued

This is an opportunity to be both a technical leader and a people leader. You'll work on high-profile Medicaid financing initiatives that impact millions of members, while helping grow the next generation of Medicaid rate development professionals.