FSA, MAAA
Professional designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
Current responsibility
Experience
Craig's expertise is in group healthcare, with an emphasis on government-sponsored programs, including Medicaid, Medicare, and special programs. His experience covers a broad range of perspectives, including payors, providers, and purchasers, helping to review the past and present in order to make strategic decisions for the future. Types of clients he has supported include the following:
- Medicaid, low-income, and uninsured programs
- Medicare Advantage (including Part D), and Medicare Supplement plan sponsors
- Other government programs (e.g., Veterans)
- Managed care organizations (HMO, PPO)
- Hospitals and physician groups
- BCBS and traditional insurance companies
- Large and small employer groups
- Collectively bargained labor unions
- Native American tribal organizations
His consulting assignments have included:
- Actuarial modeling of healthcare variables to test their impact of proposed changes to current and projected healthcare costs
- Feasibility studies for entering new markets, such as Medicare or Medicaid
- Research and data mining of large public and proprietary databases to estimate prevailing usage and unit cost for a variety of needs.
- Medicare Part C and Part D bid support
- Medicaid rate setting
- Expert testimony support
- Review and implementation of risk-adjustment algorithms
- Projecting liabilities for claims incurred but not paid
- Developing and analyzing changes to provider reimbursement contracts
- Pricing and experience analysis for collective bargaining negotiations, supporting both sides of the negotiating table (employers and unions)
- Developing regulatory rate filings for individual and group business
- Review and development of group and individual underwriting and rating models
- Projecting financial liabilities and capital needs for the Native American population
- Assessing the financial value of new healthcare technologies and practices
- Actuarial support for other nonmedical benefit types, including Rx, dental, vision, disability, and other welfare benefits
Presentations and publications
Education
- BS (honors), Actuarial Science / Mathematics, Central Washington University (Ellensburg)
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