Mercer - Talent. Health. Retirement. Investments
Talent. Health. Retirement. Investments
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    Mike Nordstrom ASA, MAAA

Partner & Lead Actuary


Mike leads the Phoenix Actuarial/Financial Sector, managing the workflow and quality of over 50 actuaries and financial analysts. As a Partner, Mike applies his actuarial background in risk and claims analysis, capitation rate setting and project planning and management for GHSC’s clients. Mike has presented at Medicaid industry conferences developed by AHIP and IIRUSA. He is Chairperson of the American Academy of Actuaries Medicaid Workgroup.  

 

Experience


Mike is currently GHSC’s lead actuarial consultant in our work with California Medicaid (Medi-Cal), New Jersey Medicaid, and Arizona Behavioral Health Services. He is the former lead actuarial consultant for our work with the Commonwealth of Massachusetts, the State of Nebraska, and Arizona Children’s Rehabilitative Services. He has provided actuarial consulting support for several additional states during his Mercer career.

Before joining Mercer in November 2000, Mike was director of actuarial services for a managed care support contractor in the Department of Defense TRICARE program. He built the start-up department, established monthly financial reserves through unpaid claim liability analysis, evaluated contract bid price adjustments and coordinated associated revenue revisions with the government. Prior to that, Mike worked for commercial health insurers for fourteen years. Mike has been in the health care actuarial field since 1983. His work has included:

  • Analyzing health care costs and trends, including actual to expected utilization and provider discounts
  • Close coordination with clinical and operational staff in the development and evaluation of benchmarks and best practices
  • Leading actuarial capitation rate development efforts and calculations, and other actuarial assignments (such as waiver cost-effectiveness calculations) for several states
  • Presentation of capitation rates and risk-sharing provisions to state, Centers for Medicare & Medicaid Services, and HMO personnel and negotiating with those HMOs

Education


Bachelor in Mathematics, University of Minnesota, Minneapolis, College of Liberal Arts Honors Program

Affiliations/Designations


Associate, Society of Actuaries

Member, American Academy of Actuaries

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