Remote Value-Based Healthcare Actuary

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

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.