Healthcare Actuarial with experience in USA

Project status
Project start date
As soon as possible
Project posted
30 Nov 2018 08:48
Project duration (approx.)
1.0 Week
Budget (approx.)
US$800 / day
Level of Experience
Mid-level
Industry
Hospital & Health Care
Area of expertise
Finance and Accounting
Consultant location
Off-site

Objectives and Key Deliverables

We are searching for healthcare actuarial experts within the healthcare space, with preferably USA healthcare sector experience. This is in preparation for a project that is likely to start very soon, and we need to have the candidate engaged in the early part of next week for preparatory activities.

Profile
- We need support in an advisory type situation to review APG (ambulatory payment group), DRG (diagnosis related group), and CPT/RVU (relative value unit) pricing methodology and calculations.
- The intent of the exercise is to align pricing to various strategic elements, such as pricing of certain services at a level that entices external collaboration or investments, or avoiding rapid inflationary healthcare spend.

Technical expertise
- Market access and reimbursement expertise, with knowledge of calculation and analysis of DRG, APG, CPT/RVU;
- Experience in defining payment and reimbursement strategies from the payer side (public or private sectors)
- Experience in developing and implementing healthcare cost containment strategies for payers (public or private sectors)
- Nice to have: market access consulting experience; with a strong focus on DRG and the other aforementioned calculations and track record of serving the payer sector (government and insurance companies) – not currently working for any consulting firm (unless freelance)

Geographical experience in the order of preference
- USA
- GCC countries, with focus on UAE
- Germany

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