Casey Smolka, FSA, MAAA
North Easton,MA
Summary
Actuarial and analytics leader with over ten years of experience in healthcare, specializing in ROI methodology, medical economics, digital health, forecasting, and pricing innovation. Skilled in communicating complex analytics to executives and clients to turn data into actionable commercial strategies and measurable financial outcomes. Proven success in leading cross-functional teams across Actuarial, Finance, Sales, Data Science, and Product. Published author and experienced presenter at SOA Health events.
Overview
12
12
years of professional experience
3
3
Certifications
Work History
Lead Product Manager, Pricing + Value Enhancement
Spring Health
New York, New York
01.2025 - Current
- Owned utilization forecasting and pricing model development, ensuring actuarial rigor and alignment with enterprise financial and growth strategy.
- Led the Pricing & Value Enhancement pod, owning product roadmap and prioritization while aligning Finance, Sales, Data Science, and Executive leadership on delivery and outcomes.
- Designed and launched innovative pricing models aligned to customer needs, competitive dynamics, and internal financial goals.
- Implemented Precision Utilization Pricing, leveraging AI and predictive modeling to materially improve forecast accuracy and directly support attainment of key revenue KPIs.
- Launched an outcomes-based pricing model selected by multiple early prospects in head-to-head competitive evaluations.
- Designed a shared-savings value-based care framework, establishing a scalable foundation for future value-based contracting and consultant-led client discussions.
Head of Actuarial Analytics
Spring Health
New York, New York
11.2022 - Current
- Co-developed Spring Health’s enterprise ROI methodology—published in JAMA Network Open and certified twice by the Validation Institute—establishing an industry-leading standard for mental health ROI measurement.
- Created and launched Spring Health’s ROI Performance Guarantee, now embedded across all new and renewal contracts to strengthen sales competitiveness, renewal confidence, and consultant credibility.
- Owned the external-facing role for ROI results, conducting comprehensive analysis, crafting narratives, presenting findings, and engaging with executives, customers, consultants, and internal leadership.
- Acted as the primary actuarial and value partner to consultants including Brown & Brown, Aon, MMA, and WTW—aligning on ROI methodology, pricing structure, and client value narratives.
Head of Actuarial Analytics
K Health
New York, New York
07.2021 - 11.2022
- Established actuarial and financial analytics capabilities to enhance digital advanced primary care model.
- Led utilization projection and revenue forecasting for enterprise partnerships and payer engagements.
- Developed client-facing financial value models demonstrating measurable clinical and cost savings.
- Supported payer strategy and value-based contracting analytics, focusing on performance measurement and settlement methodologies to optimize outcomes.
Senior Actuarial Manager
Blue Cross Blue Shield of Massachusetts
Boston, MA
05.2020 - 07.2021
- Led the analytic roadmap and delivery for the Advanced Business Analytics team, supporting enterprise-wide strategic and financial initiatives.
- Managed and developed actuarial and analytics talent, mentoring early-career professionals and strengthening analytic capability.
- Developed COVID-19 stochastic cost models used directly in enterprise financial planning and reserving.
Actuarial Manager
Blue Cross Blue Shield of Massachusetts
Boston, MA
07.2019 - 05.2020
- Functioned as product owner for the Member Engagement Data Mart (MEDM), facilitating integrated analysis of program participation and claims data.
- Directed customer-facing analytics delivery within agile pod structures, translating business needs into actionable insights that enhanced client engagement.
- Delivered Medicare Advantage segmentation and emerging trend analytics to inform senior leadership decision-making.
Actuarial Consultant
Blue Cross Blue Shield of Massachusetts
Boston, MA
03.2017 - 07.2019
- Forecasted pharmacy trends and evaluated vendor pricing proposals, negotiating contracts that achieved $1B in savings.
Actuarial Analyst
Blue Cross Blue Shield of Massachusetts
Boston, MA
02.2015 - 03.2017
- Assessed savings opportunities for medical economic initiatives to guide strategic decision making and pricing strategies
Actuarial Analyst
Humana
Louisville, Kentucky
02.2014 - 02.2015
- Contributed to quarterly trend forecasting and financial analysis for individual insurance market, influencing strategic decisions.
Education
Bachelor of Science - Actuarial Science
University of Connecticut
Storrs, CT01-2013
Skills
- Pricing Strategy
- Pricing model development
- ROI Models
- ROI Methodology
- Value-based care
- Utilization forecasting
- Data Product Leadership
- Product roadmapping
- Stakeholder management
- Cross-Functional Leadership
- Team leadership
- Data visualization
- Executive Communication
- Customer and Consultant Communication
Accomplishments
Hawrilenko M, Smolka C, Ward E, et al.
“Return on Investment of Enhanced Behavioral Health Services.” JAMA Network Open. 2025.
“Return on Investment of Enhanced Behavioral Health Services.” JAMA Network Open. 2025.
Certification
Fellow of the Society of Actuaries - 2021
Timeline
Lead Product Manager, Pricing + Value Enhancement
Spring Health
01.2025 - Current
Head of Actuarial Analytics
Spring Health
11.2022 - Current
Head of Actuarial Analytics
K Health
07.2021 - 11.2022
Senior Actuarial Manager
Blue Cross Blue Shield of Massachusetts
05.2020 - 07.2021
Actuarial Manager
Blue Cross Blue Shield of Massachusetts
07.2019 - 05.2020
Actuarial Consultant
Blue Cross Blue Shield of Massachusetts
03.2017 - 07.2019
Actuarial Analyst
Blue Cross Blue Shield of Massachusetts
02.2015 - 03.2017
Actuarial Analyst
Humana
02.2014 - 02.2015
Bachelor of Science - Actuarial Science
University of Connecticut