Senior Consulting Actuary - Risk Adjustment

Overview

Wakely, an HMA company, is seeking a highly motivated Senior Consultant with specialized experience in Affordable Care Act (ACA) risk adjustment analytics. This role will lead client engagements, coordinate multidisciplinary teams, develop actionable recommendations, and support the continued growth of Wakely’s risk adjustment offerings. The ideal candidate brings strong knowledge of ACA risk adjustment including setting risk accruals, experience working with EDGE data and risk adjustment operational teams, sound project leadership skills, and the ability to communicate complex concepts clearly to senior leaders.

Key Responsibilities:

• Client Leadership & Communication:
• Serve as a primary point of contact for clients, partnering with actuarial, coding, data, and operational experts to deliver integrated solutions and communicate findings effectively.
• Project & Team Leadership:
• Develop and manage project plans, timelines, workflows, and deliverables across multiple engagements while mentoring junior staff and maintaining high-quality work.
• Risk Adjustment Analytics:
• Lead ACA risk adjustment analyses, including accrual development, EDGE data evaluation, provide strategic support to health plan executives, and assessments of financial and operational impacts.
• Client Deliverables & Presentations:
• Draft clear, actionable deliverables and present results, recommendations, and risk adjustment concepts to client leadership.
• Product & Methodology Proficiency:
• Apply Wakely tools, products, methodologies, and risk adjustment expertise to address client needs and support internal initiatives.
• Business Development Support:
• Contribute to requests for proposals, proposal development, strategic scoping discussions, service innovation, and the growth of Wakely’s risk adjustment offerings.
• Market & Regulatory Insight:
• Monitor ACA risk adjustment developments and help translate market and regulatory changes into practical strategies for clients.
• Cross-Functional Collaboration:
• Coordinate with actuarial, coding, operations, data analytics, and other multidisciplinary teams to deliver comprehensive client solutions.

What We're Looking For:

• Demonstrated experience leading ACA risk adjustment analytics within a health plan or leading strategic risk adjustment consulting engagements.
• Deep understanding of the ACA risk adjustment program and its impact on health plan rate filings and financial performance.
• Strong knowledge of the full risk adjustment lifecycle, including coding, submissions, analytics, provider engagement, and regulatory requirements.
• Proven ability to manage projects, workflows, timelines, and deliverables across multiple engagements.
• Strategic perspective with the ability to anticipate market or regulatory changes and translate them into actionable client recommendations.
• Ability to build trusted client relationships and communicate complex technical, analytical, and operational concepts clearly to senior leadership.
• Demonstrated leadership, initiative, accountability, and sound judgment in client and team interactions.
• Commitment to mentoring team members and contributing to a collaborative learning environment.
• Excellent written and verbal communication skills, with proven success working across cross-functional and multidisciplinary teams.

Job Summary

The Senior Consulting Actuary I is responsible for managing Wakely’s client relationships by designing and monitoring plans to achieve strategic goals.  In addition, the position will manage actuarial project teams to ensure quality and timely deliverables. This role has supervisory responsibilities.

Responsibilities

Work Performed and Job Requirements

• Client Management - Develop and Maintain Client Relationships
  • Implement initiatives for Wakely products, tools and services through training and regular meetings
  • Manage and understand individual client needs and develops a strategic plan to meet those needs
  • Manage client relationships to include client visits, ongoing correspondence and feedback
  • Mitigate risk by ensuring client contracts, documentation and processes are followed
• Project Management - Supervise and Account for the Execution of Project Plan
  • Conduct periodic reviews of project plans, final deliverables and post project results
  • Oversee project communication and provide venues for constructive feedback
  • Ensure project team is providing quality deliverables, updates and billing clients within timelines
  • Appropriate delegation of work
• Professional/Industry Development – Gain and Sustain Professional/Industry Knowledge
  • Maintain credentials, signing authority and health care knowledge through continuing education
  • Implement industry training for internal/external initiatives
  • Identify needs and align employee career path plans
  • Manage the creation of additional resources and reference materials
• New Business Development – Seek Opportunities for the Organization's Growth
  • Implement brand recognition through participating in seminars/events and research papers, etc.
  • Generate new business and/or product lines by executing on established action plans
  • Manage new marketing initiatives to generate sales leads
  • Introduce new value add services to current clients
• Internal Operations - Manage Best Business Practice
  • Prioritize and manage operational efficiency initiatives
  • Administer compliance of policies and procedures to ensure cross office collaboration
  • Recruit top talent and participate in the selection and orientation process
  • Oversee and participate in community and professional volunteer activities/opportunities
• All other duties as assigned.

Qualifications

Education/Training

Minimum of a bachelor’s degree in actuarial science, mathematics, economics, or statistics required. FSA designation or ASA designation with additional experience also required.

Experience

Minimum of 8 years of healthcare actuarial experience in one of more of Wakely’s core areas (Medicaid, healthcare reform, ACA, Provider Sponsored Organizations and Medicare Advantage), with at least 2 years of project management or client management experience required.

Knowledge, Skills, and Abilities

• Initiative - Ability to decide in an independent way what actions should be taken
• Effective Communication - Demonstrates the ability to convey thoughts and express ideas effectively, both verbally and written
• Team Player - Builds constructive working relationships characterized by a high level of acceptance, cooperation, and mutual respect
• Time Management - Makes reasonable estimates of resources needed to achieve goals or complete projects. Uses methods to plan and track work and commitments
• Continuous Learning - Displays an ongoing commitment to increasing skills
• Leadership - Develops the ability of others to perform and contribute to the organization by providing ongoing feedback and opportunities to learn through formal and informal methods
• Emotional Intelligence - Consistently exercises sound judgment
• Strategic Thinking - Formulates objectives and priorities, and implements plans consistent with the long-term interest of the organization and employees

EEO

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)

Additional Info

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