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.
- 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.
- 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
- GCC countries, with focus on UAE