Manager, Actuarial Services - Medicaid

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Eligibility Requirement:  To qualify for the Manager, Actuarial Services role, applicants must hold a bachelor’s degree, have earned at least an ASA (Associate of the Society of Actuaries) designation, and possess a minimum of five years of actuarial experience.

To support business needs, the expected work schedule will align with the PST time zone. Evening and weekend availability may be required based on business priorities. Applicants may work remotely from anywhere within the Continental United States.

Position purpose: This position will serve as a key actuarial leader for the Coordinated Care Medicaid health plan in Washington State.

The Manager, Actuarial Services is responsible for leading actuarial functions that support financial performance of Coordinated Care of Washington. This role oversees the preparation and submission of annual data for rate setting and Medical Loss Ratio (MLR) reporting, ensuring compliance with state and federal regulatory requirements. The position also provides expertise and technical support to ensure the financial soundness of the company’s health plan operations.

In this Manager, Actuarial Services role, you will: 

• Lead annual cost model submission, managing a cross functional team from Actuarial, Finance, Data & Analytics, and Accounting
• Lead annual MLR submissions
• Support analysis of key Value Based Agreements
• Support annual and off cycle rate advocacy
• Support quarterly and annual forecast development
• Support Inpatient reserving for Medicaid, Marketplace, and Medicare lines of business
• Proactively identify opportunities for savings and efficiencies by analyzing Medical trends
• Support Revenue reconciliation activities
• Apply knowledge of mathematics, probability, statistics, principles of finance and business to calculate financial outcomes.
• Research and identify new business opportunities
• Work with State agencies to assess impact of program/policy changes
• Performs other duties as assigned
• Complies with all policies and standards

Why this role is appealing: The opportunity to interact with senior leaders within the organization. This exposure allows candidates to develop and deliver valuable insights related to the financial health of the company. The role is part of a collaborative team where individuals are encouraged to contribute and share ideas.

Education/Experience:  Bachelor's degree or in related field or equivalent experience. 5+ years of actuarial, mathematical, statistical, scientific, financial analysis, reporting, data analytics, accounting, and/or underwriting experience.

License/Certification:  Fellow or Associate of the Society of Actuaries (or equivalent international certification) required and Member of American Academy of Actuaries (or equivalent international membership) required.

Highly Preferred Skills and Experience:

• Experience working with Medicaid programs
• Ability to effectively communicate actuarial insights to non-actuarial stakeholders, influencing decision-making by translating complex analyses into clear, actionable recommendations
• Lead responsibilities for annual cost model submissions and MLR reporting
• Ability to identify cost savings and operational efficiencies through analysis of medical trends
• Support for key actuarial and finance functions, including Value-Based Agreements, rate advocacy, forecasting, inpatient reserving, and revenue reconciliation
• Proficiency in SQL, Excel, Microsoft Office, and Access. 
• Familiarity with Power BI, VBA, and OneStream is a plus but not essential

Important Note:  To be considered for this position, candidates must hold an ASA (Associate of the Society of Actuaries) designation, possess a bachelor’s degree, and have a minimum of five years of actuarial experience.