Managing Actuary - Medicaid Rate Advocacy

CareSource Management Group Company

Job Overview

Location

Remote

Job Type

Full-time

Full Job Description

📋 Description

• The Managing Actuary - Medicaid Rate Advocacy role is critical to CareSource’s financial integrity and strategic positioning in the Medicaid marketplace, providing actuarial leadership that directly influences rate adequacy, regulatory compliance, and sustainable growth across multiple state lines of business.
• This position ensures that actuarial processes—including pricing, forecasting, reserving, and rate filings—are rigorously executed, transparently communicated, and aligned with both corporate objectives and evolving federal and state Medicaid requirements.
• Day-to-day responsibilities include leading the development and maintenance of actuarial models used for actual-to-expected experience reporting, reserve calculations (including IBNR), bid pricing, and contracting models; owning end-to-end actuarial processes for assigned lines of business, particularly Medicaid rate advocacy; collaborating with external vendors and internal stakeholders to validate assumptions and data integrity; performing baseline analyses on projected rate changes and coordinating with state and federal agencies to support timely and defensible rate filings; reviewing and approving monthly IBNR reserve estimates across all CareSource lines of business; mentoring and developing actuarial staff while fostering a culture of accountability, precision, and continuous improvement; and presenting complex actuarial findings and strategic recommendations to senior leadership and cross-functional teams in clear, actionable formats.
• The actuarial team at CareSource operates as a strategic partner to finance, underwriting, contracting, and executive leadership, working within a mission-driven organization dedicated to improving health outcomes for underserved populations through innovative, affordable healthcare solutions; the team values collaboration, technical excellence, and proactive engagement with regulatory bodies to ensure long-term viability of Medicaid programs.
• In this role, the incumbent will deepen expertise in Medicaid rate setting methodologies, gain influence over multi-state regulatory strategies, enhance leadership and people management capabilities, and develop a nuanced understanding of how actuarial science intersects with public policy, healthcare economics, and corporate strategy—positioning them for advancement into senior actuarial or enterprise risk management roles within the healthcare sector.

🎯 Requirements

• Bachelor’s degree in actuarial science, mathematics, economics, or a related field (or equivalent relevant work experience)
• Associate of the Society of Actuaries (ASA) certification required; Fellow (FSA) preferred
• 2–3+ years of actuarial experience, preferably in managed care or healthcare settings
• 2–3+ years of management or supervisory experience preferred
• Demonstrated experience leading Medicaid rate advocacy in at least one state
• Strong proficiency in SQL, SAS, R, Python, or other data manipulation tools; expert-level Excel skills required
• Advanced proficiency in Microsoft Word and PowerPoint for technical communication and presentation

🏖️ Benefits

• Competitive salary range of $94,100.00 – $164,800.00, with potential for performance-based bonuses
• Comprehensive total rewards package supporting employee well-being, including health, dental, vision, retirement savings, and paid time off
• Remote work flexibility with minimal travel required (<10% of time)
• Opportunities for professional development, leadership growth, and engagement with state and federal healthcare policy initiatives
• Support for continuing education, certification maintenance, and actuarial skill enhancement through training and resources
• Inclusive, collaborative workplace culture focused on fostering belonging, partnership, and personal excellence

Skills & Technologies

Python

Remote

Degree Required

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CareSource Management Group Company

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About CareSource Management Group Company

CareSource is a nonprofit, multi-state managed care organization headquartered in Dayton, Ohio. Founded in 1989, it administers Medicaid, Medicare Advantage, and Marketplace health plans serving over two million members in Ohio, Kentucky, Indiana, West Virginia, and Georgia. The company focuses on improving health outcomes for low-income and vulnerable populations through integrated care management, behavioral health services, and social determinants programs.

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