Full Job Description
Performs advanced and/or managerial (senior-level) actuarial work. Work involves providing professional actuarial advice and consultation; participating in the development and implementation of improved actuarial policies and procedures; and assisting in the preparation, interpretation, and enforcement of orders or mandates directed from an outside entity such as the Centers for Medicare & Medicaid Services (CMS), the Texas State Legislature, an actual court order issued by a judge or a state statute relating to actuarial matters. Responsibilities include planning, assigning, and/or supervising the work of others. Works under minimal supervision, with considerable latitude for the use of initiative and independent judgment.
Essential Job Functions:
The Actuary IV is responsible for assisting the Chief Actuary of the Actuarial Analysis Department. Actuarial Analysis calculates the capitation rates paid to Medicaid and Children's Health Insurance Programs (CHIP) managed care organizations (MCOs). The department is also involved with benefit and rate changes, program expansions, and legislative mandates that involve MCOs. The department also completes portions of the required federal waiver filings with Centers for Medicare & Medicaid Services (CMS) for 1915(b) waivers, including the and Non-Emergency Medical Transportation (NEMT). In addition, the department provides actuarial support services for other HHSC initiatives. The Actuary IV may advise HHSC Executive staff on issues relating to capitation rates for MCOs, and may interface with HHSC Executive staff, HHSC Program staff, Legislative staff, and the MCOs on rates and other actuarial issues.
Other duties will include, but are not limited to:
Overseeing actuarial research assignments.
Reviewing actuarial opinions, reports, and memorandums.
Reviewing annual statements, reinsurance agreements, and mergers.
Reviewing risk-rating methodologies.
Assessing the impact of existing and proposed legislation or policies on agency programs with regard to actuarial matters and providing input on rules and proposed legislation.
Preparing and presenting information regarding the actuarial process and assumptions to external audiences.
Preparing executive actuarial reports.
Planning, assigning, and/or supervising the work of others.
Performing related work as assigned.
Knowledge Skills Abilities:
Knowledge of generally acceptable actuarial principles and practices.
Knowledge of Medicaid and CHIP capitation rate setting.
Knowledge of Medicaid and CHIP programs.
Knowledge of Medicaid and CHIP capitation rate setting federal regulations.
Knowledge of databases and the ability to build, maintain and query using SQL Server.
Knowledge and extensive use of computer software particularly Microsoft Excel.
Knowledge of and the ability to apply statistical analysis.
Skill in applying actuarial principles and techniques.
Ability to interpret insurance regulations and procedures.
Ability to communicate effectively; and to plan, assign, and/or supervise the work of others.
Registration or Licensure Requirements:
Prefer member of the Society of Actuaries and American Academy of Actuaries.
Initial Selection Criteria:
Graduation from an accredited four-year college or university with major coursework in statistics, mathematics, actuarial science, or a related field is required. A minimum of three (3) to five (5) years of experience in actuarial or statistical analysis work. Management experience is preferred.
Note: There may be no military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position. All active duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information see the Texas State Auditor’s Military Crosswalk at http://www.hr.sao.state.tx.us/Compensation/JobDescriptions.aspx.
HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.
I-9 Form - Click here to download the I-9 form.
In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.