actuarial director resume example

Independent consulting actuary providing advice to clients in the areas of reserving, payer contract negotiations, Medicaid regulatory changes, Knox Keene plan filings, and Medicare risk adjustment.

Collaborated with leadership team to onboard new external clients for Medicare risk adjustment services, ensuring service levels and providing top-notch expertise.

Forecasted Medicare risk adjustment revenue streams and supported year end audits on behalf of internal and external clients.

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Established the Medicare trend research team, working with the Chief Medical Officer to shape clinical strategy and providing research to support public healthcare policy decisions. 

Led the development of the 2006 Medicare Advantage Part C bids, coordinating pricing assumptions, bid reviews, and ensuring accurate bid submissions to CMS.