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Role Summary

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HIGHLIGHTS

Manager-level health actuary role based in Richmond, VA supporting Medicaid and CHIP capitation rate setting. You’ll lead the Capitation Rate Setting team to calculate, validate, and submit actuarially sound capitation rates, manage actuarial contractors, and ensure federal/state compliance. The role requires an ASA and strong financial modelling and stakeholder communication skills.

JOB DESCRIPTION SUMMARY

  • Lead Capitation Rate Setting team for Medicaid and CHIP in Virginia
  • Calculate, validate, and submit actuarially sound capitation rates
  • Manage actuarial contractors and ensure federal/state compliance
  • Work on-site as needed in Richmond with some telework subject to policy
  • Requires ASA and strong Excel plus experience with SAS or similar

DOMAIN EXPERTISE

  • Medicaid and CHIP capitation rate setting
  • managing capitation reimbursement activities and financial modelling
  • interpreting and applying state and federal regulations for managed care
  • advanced healthcare financial analysis of large datasets
  • advanced Microsoft Excel for healthcare financial analysis

KEY REQUIREMENTS

  • Must be an Associate of the Society of Actuaries (ASA)
  • Considerable experience managing capitation rate-setting activities
  • Considerable experience interpreting state and federal managed care regs
  • Considerable experience analyzing large healthcare datasets and reporting
  • Eligible to work in the US without employment-based sponsorship

TECH STACK

  • Excel
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Role Summary

Loading...

HIGHLIGHTS

Manager-level health actuary role based in Richmond, VA supporting Medicaid and CHIP capitation rate setting. You’ll lead the Capitation Rate Setting team to calculate, validate, and submit actuarially sound capitation rates, manage actuarial contractors, and ensure federal/state compliance. The role requires an ASA and strong financial modelling and stakeholder communication skills.

JOB DESCRIPTION SUMMARY

  • Lead Capitation Rate Setting team for Medicaid and CHIP in Virginia
  • Calculate, validate, and submit actuarially sound capitation rates
  • Manage actuarial contractors and ensure federal/state compliance
  • Work on-site as needed in Richmond with some telework subject to policy
  • Requires ASA and strong Excel plus experience with SAS or similar

DOMAIN EXPERTISE

  • Medicaid and CHIP capitation rate setting
  • managing capitation reimbursement activities and financial modelling
  • interpreting and applying state and federal regulations for managed care
  • advanced healthcare financial analysis of large datasets
  • advanced Microsoft Excel for healthcare financial analysis

KEY REQUIREMENTS

  • Must be an Associate of the Society of Actuaries (ASA)
  • Considerable experience managing capitation rate-setting activities
  • Considerable experience interpreting state and federal managed care regs
  • Considerable experience analyzing large healthcare datasets and reporting
  • Eligible to work in the US without employment-based sponsorship

TECH STACK

  • Excel

Job Overview

Salary
$116k - $159k
Work Type
Permanent
Full Time

Ideal Candidate Profile

A Manager-level health actuary (ASA) with strong Medicaid/CHIP capitation rate-setting experience who leads teams, builds financial models, and uses Excel and SAS to produce compliant rate submissions.

ASA

Benefits

Hybrid Work
Shortlist Forming
Closing Soon
76d
76 days ago

Strategy: Speed over Perfection

By Day 21, visibility drops significantly. Recruiters are focusing on existing candidates.

"Don't wait for a cover letter. The requisition could close tomorrow. Apply now."

Job Overview

Salary
$116k - $159k
Work Type
Permanent
Full Time

Ideal Candidate Profile

A Manager-level health actuary (ASA) with strong Medicaid/CHIP capitation rate-setting experience who leads teams, builds financial models, and uses Excel and SAS to produce compliant rate submissions.

ASA

Benefits

Hybrid Work
Shortlist Forming
Closing Soon
76d
76 days ago

Strategy: Speed over Perfection

By Day 21, visibility drops significantly. Recruiters are focusing on existing candidates.

"Don't wait for a cover letter. The requisition could close tomorrow. Apply now."

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Health/Government Regulator/Manager Level
V

Healthcare Reimbursement Manager

Virginia Department of Human Resource Management•Richmond, United States•2mo ago
HybridMedicaidHealth OtherPricing & Rating