Healthcare Actuary for Payer Contracting and Cost Modeling

Healthcare Actuary for Payer Contracting and Cost Modeling

Healthcare Actuary for Payer Contracting and Cost Modeling

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4 hours ago

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About

Axis Growth Partners is a boutique commercialization consulting firm working with leading behavioral health, metabolic, MSK, and digital health companies. We develop payer-ready economic models, continuity-of-care analyses, and total cost-of-care contracting strategies for regional and national health plans. We are seeking a fractional healthcare actuary to provide actuarial validation, trend adjustments, and payer-aligned economic review across multiple client projects. This is NOT a full-time role and NOT regulatory rate filing work. We need someone who can ensure that our cost-trajectory, PMPM, ROI, and attribution models reflect standard payer actuarial practices and withstand CFO/health plan scrutiny. Responsibilities: • Review ROI and total cost of care models for actuarial consistency • Validate assumptions, trend, variance, utilization modeling, and PMPM math • Normalize data into payer-standard structures (commercial, Medicaid, ASO) • Provide actuarial language for payer packets and contracting materials • Advise on confidence intervals, comparison groups, confounder controls • Recommend adjustments that improve credibility with health plans • Occasional review of guarantee/risk-corridor structures • 5–10 hours per project; ongoing work across multiple clients Requirements: • Prior experience at a health plan actuarial team, Optum, Milliman, Mercer, Oliver Wyman Actuarial, or a similar payer-focused environment • Strong skills in medical cost modeling, trend, PMPM logic, utilization curves • Understanding of digital health or behavioral/metabolic economics a plus • Ability to review work produced by analysts/modelers and provide clear feedback • Excellent written communication for actuarial documentation • Fast turnaround (2–5 day cycles) • No regulatory FSA/ASA signature required — payer experience is what matters Deliverables: • Short actuarial review memos • Suggested adjustments to cost/ROI models • Actuarial-consistent language for payer packets • Recommendations to ensure contracting credibility • Optional “actuarial validation” line for deliverables Hours: 5–15 hours/month depending on pipeline. This is a long-term relationship with consistent work. Applicants with payer-side actuarial backgrounds or experience validating digital health economic models will be prioritized.