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.

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

Applicants may work remotely from anywhere within the Continental United States. 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.

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.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act