Actuarial Manager

Virginia Information Technologies Agency • Richmond, VA

1d

About The Position

The Department of Medical Assistance Services (DMAS) is excited to offer a
competitive opportunity to serve as the Actuarial Manager in the Provider Rate
Development Division.

Job responsibilities will include, but are not limited to:

The Actuarial Manager leads the Capitation Rate Setting team in the Provider
Rate Development Division, overseeing all activities related to the calculation,
validation, and submission of actuarially sound Medicaid and CHIP capitation
rates for the Commonwealth of Virginia. This role ensures compliance with
federal and state requirements, effective management of actuarial contractors,
and the delivery of timely, high quality financial analysis to agency leadership
and stakeholders. By leveraging advanced data analysis, actuarial expertise, and
proactive stakeholder collaboration, the position supports the financial
sustainability of contracted Managed Care Organizations (MCOs) and enhances the
efficiency and transparency of provider reimbursement processes. The Actuarial
Manager applies sound actuarial judgment to address complex challenges,
safeguard public resources, maintain public trust, and advance DMAS’s mission to
provide high quality health care coverage for Virginians.

Must attach copy of ASA certification or completed exam results.

The business needs for this position have in office requirements to include but
are not limited to attending in-person division meetings and attending internal
and external stakeholder’s meetings.

Located in beautiful Central Virginia, the Richmond area puts you just 2 hours
from the Blue Ridge Mountains, Virginia Beach and Washington DC. To learn more
about the Richmond, VA area visit: https://www.virginia.org/

The Department of Medical Assistance Services (DMAS) is working to improve the
health and well-being of Virginians through access to high quality health care
coverage.

DMAS wants talented individuals who can align their experience with the mission
of the agency and its core values – service, collaboration, trust, problem
solving and adaptability.

At the Department of Medical Assistance Services (DMAS) we encourage and promote
that you Come as you are | Become who you want to be | That is our promise.

Requirements

• Must have a commitment to achieving an Associate of the Society of Actuaries (ASA) designation as demonstrated by successfully passing at least one ASA exam and complete the ASA certification within 24 months.
• Experience in finance, specifically in analyzing complex datasets to draw actionable conclusions and recommendations, as well as preparing detailed reports.
• Considerable experience managing capitation reimbursement activities, including rate setting, financial modeling processes, and interpretation of state and/or federal regulations governing managed care programs.
• Considerable knowledge of Medicaid reimbursement and capitation rate setting methodologies utilized by government agencies and private purchasers of healthcare services.
• Considerable experience in finance, including analyzing complex healthcare datasets to draw actionable conclusions and preparing detailed written reports.
• Considerable experience designing and implementing processes and procedures for advanced financial analysis, including statistical and quantitative methods, using Microsoft Excel or similar tools.
• Considerable experience supervising professional staff, including setting performance expectations, providing feedback and coaching, and managing workloads and project timelines.
• Considerable experience conducting in-depth research on public policy issues, with a focus on health policy and budget analysis, and interpret findings to inform decision-making.
• Considerable experience communicating effectively with internal and external stakeholders, including demonstrated ability to prepare and present written and oral reports on complex financial or policy issues.

Nice To Haves

• Experience in database programming (SAS or similar) to extract and analyze data.
• Associate of the Society of Actuaries (ASA).

Responsibilities

• The Actuarial Manager leads the Capitation Rate Setting team in the Provider Rate Development Division, overseeing all activities related to the calculation, validation, and submission of actuarially sound Medicaid and CHIP capitation rates for the Commonwealth of Virginia.
• This role ensures compliance with federal and state requirements, effective management of actuarial contractors, and the delivery of timely, high quality financial analysis to agency leadership and stakeholders.
• By leveraging advanced data analysis, actuarial expertise, and proactive stakeholder collaboration, the position supports the financial sustainability of contracted Managed Care Organizations (MCOs) and enhances the efficiency and transparency of provider reimbursement processes.
• The Actuarial Manager applies sound actuarial judgment to address complex challenges, safeguard public resources, maintain public trust, and advance DMAS’s mission to provide high quality health care coverage for Virginians.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed
• Number of Employees: 1-10 employees