Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
First Resume Review: 02/05/2020
This position will remain open until filled.
Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid Agency, is driven by the passion to deliver comprehensive and cost effective health care to Arizonans in need. AHCCCS is nationally acclaimed as a model for other Medicaid programs and recipient of multiple awards for excellence in workplace effectiveness and flexibility. AHCCCS employs more than 1,000 people across the state providing Medicaid coverage to over 1.8 million Arizonans. The AHCCCS Division of Health Care Management (DHCM) Actuarial Team is centrally located in downtown Phoenix, and is directly responsible for setting capitation rates each year providing over $11.5 billion in payments to Managed Care Organizations (MCOs) responsible for providing integrated physical and behavioral health services to members in five distinct programs within Arizona’s Medicaid landscape. The actuarial team also works throughout the year to: analyze new benefits and programmatic changes; review actual to expected results of our MCO partners; respond to requests from the legislature and other stakeholders on a multitude of topics; and work through a variety of other ad hoc projects which actuaries are uniquely situated to tackle.
AHCCCS employees are highly engaged, collaborative and embrace a culture of public service, while continuously striving to improve on past results. If this sounds like you, read on!
All Arizona state employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government whereby every employee reflects on performance, reduces waste, and commits to continuous improvement with sustainable progress. Through AMS, every state employee seeks to understand customer needs, identify problems, improve processes, and measure results. State employees are highly engaged, collaborative and embrace a culture of public service. Visit our careers page to learn more about AHCCCS. Use your skills to benefit others; join the AHCCCS Team!
The Division of Health Care Management (DHCM) is looking to immediately hire a highly motivated individual to join our team as an Actuary. This position will provide actuarial expertise and services to AHCCCS by developing actuarially sound capitation rates, and determining reasonable and appropriate adjustments to capitation rates based on trends, changes in AHCCCS policies, rules, state statutes, federal rules and federal laws. The position will involve review and pricing for multiple AHCCCS programs. Major duties and responsibilities include but are not limited to:
* Developing actuarially sound capitation rates for the AHCCCS programs, including the following (non-exhaustive)
* completion factor development
* encounter to claim comparisons
* trend analysis
* medical cost projections
* non-benefit cost projections
* analysis of changes (legislative mandates, Pharmacy & Therapeutics (P&T) committee decisions, additional administrative requirements, added program benefit or fee schedule changes, to name just a few) for financial impact
* reinsurance offset development
* MCO and CMS communication (including actuarial certification of capitation rates)
* Developing models to help with actuarial analysis.
* Monitoring actual to expected experience from the MCOs
* Developing and maintaining documentation and provide data to external regulatory agencies
* Performing ad hoc actuarial projects and other duties as assigned or requested
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Excellent writing and verbal communication skills
* Excellent knowledge of computer techniques used in research and analysis
* Effective listening and questioning skills
* Strong analytical ability and able to plan and conduct complex actuarial studies
* Strong ability to manage competing priorities, and capability to switch between projects without losing momentum
* Analyze complex data and draw valid conclusions and prepare accurate comprehensive reports.
* Bachelor’s degree in actuarial science, math, or related field
* Preferred designation of Fellow of the Society of Actuaries (FSA)
* Two years of actuarial experience
* Experience related to health care actuarial services, especially within a managed care environment
* Extensive knowledge of Medicaid health insurance analysis
* Intermediate to advanced programming skills preferred
LICENSE(S) AND/OR CERTIFICATION(S):
* Minimum designation of Associate of the Society of Actuaries (ASA) and Member of the American Academy of Actuaries (MAAA)
At AHCCCS, we promote the importance of work/life balance by offering workplace flexibility and a variety of learning and career development opportunities. Among the many benefits of a career with the State of Arizona, there are 10 paid holidays per year, accrual of sick and annual leave, affordable medical benefits and participation in the Arizona State Retirement Plan. Click here to learn more about benefits.
Arizona State Government is an EOE/ADA Reasonable Accommodation Employer. Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by calling (602) 417-4497. Requests should be made as early as possible to allow sufficient time to arrange the accommodation. AHCCCS is an Equal Employment Opportunity Employer. All newly hired employees will be subject to E-Verify Employment Eligibility Verification.
Click the APPLY NOW button to submit your application.
For technical assistance, email HRIShelpdesk@azdoa.gov or call 602-542-4700.