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Justin Birrell, FSA, MAAA

Principal & Consulting Actuary
Seattle, WA, US

Tel: +1 206 5045548

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Professional Designations

  • Member, American Academy of Actuaries (MAAA), 2007
  • Fellow, Society of Actuaries (FSA), 2010

Education

  • BS, Mathematics, Brigham Young University

Current Responsibility

Justin is a principal and consulting actuary with Milliman's Seattle office. He joined the firm in 1995.

Experience

Justin has 20 years of actuarial experience with a variety of health-related issues. His primary focus over the last 15 years has been Medicaid. This has involved work for states including Hawaii, Idaho, Nevada, Utah, Washington, and Vermont, as well as non-state clients working with Medicaid populations in Kentucky, Arizona, Georgia, and Massachusetts.

He has worked on a variety of projects, including medical, long-term care, behavioral health, transportation, disease management, procurement, healthcare reform, and other state-specific analyses. In addition to the development of capitation rates, Justin has worked with states to negotiate final rates and produce required CMS documentation.

His experience includes:

  • Current work in multiple states to develop rates and an appropriate structure integrating both the Medicare and Medicaid component of costs into a rate for members eligible for both programs
  • Experience in developing rate structures for integrated (medical, mental health, chemical dependency, and long-term care) healthcare models for Medicaid recipients that improve healthcare and reduce expenditures, including CMS documentation of rates and rate structures
  • Expertise in the development and documentation of Medicaid capitation rates in multiple states for managed care services for TANF, aged, blind, disabled, and other unique Medicaid populations, including those eligible for Medicare as well as those only eligible for Medicaid benefits
  • Experience in documentation of cost effectiveness for Medicaid programs
  • Experience risk adjusting Medicaid capitation rates
  • Experience in developing non-emergency transportation rates for Medicaid populations
  • Expertise in analyzing large claims databases and healthcare modeling
  • Experience in developing prescription drug formularies
  • Expertise in Medicaid disease management financial savings analyses and analysis of soundness of disease management rates
  • Work with state agencies to project impact of benefit and enrollment changes including the impact of PPACA legislation on state expenditures
  • Design and evaluation of pay-for-performance incentives in Medicaid-managed care programs
  • Assisted the State of Washington in its SIM grant proposal
  • Projections of expenditures for Medicaid expansion in Washington, Hawaii, and Idaho

Affiliations

  • Member, Society of Actuaries
  • Member of the American Academy of Actuaries
  • Work at Milliman

    • “I was offered a chance to come in, shake things up, create something."
    Work at Milliman