Medicaid Rate Development Consultant - Senior Leader

Selby Jennings; United States; On-site; USD 180,000 - 240,000; Full time

Job summary

Selby Jennings is partnering with a leading healthcare consulting organization to identify a senior Medicaid rate development expert. The role centers on hands-on data, analytics, financial modeling, and actuarial support used to develop and evaluate managed care rates for Medicaid.

You will analyze claims and cost data, evaluate cost trends, and collaborate with state Medicaid agencies and actuaries on forecasting and financing initiatives, while mentoring junior consultants and communicating

Qualifications

• 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.

Responsibilities

• 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

Skills

Quantitative analytics

Financial modeling

Excel proficiency

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 actuarial, 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.