Medicaid Rate Development Consultant - Senior Leader
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 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.