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Medicaid Actuary

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Medicaid Actuary

Salary

$72,238.40 - $111,238.40 Annually

Location

Des Moines - 50319 - Polk County, IA

Job Type

Full-time

Job Number

26-01283

Agency

400 Health & Human Services - Medicaid

Opening Date

11/18/2025

Closing Date

12/2/2025 11:59 PM Central

LinkedIn Tag

#LI-POST

Point of Contact

Soraya Miller - [email protected]

+ Description

+ Benefits

+ Questions

Job Description

The Iowa Department of Health and Human Services (HHS), Division of Medicaid, Bureau of Budget and Planning is seeking a Medicaid Actuary to join our team!

The Medicaid Actuary is a critical member of the Medicaid Finance, Bureau of Budget and Planning, responsible for leading and supporting actuarial and financial analysis related to the Medicaid managed care program. This includes development and monitoring of capitation rate setting, analysis of Medical Loss Ratios (MLRs), Pay-for-Performance (P4P) evaluations, risk corridors, and reconciliation of financial reporting submitted by Managed Care Organizations (MCOs) and Dental Plans.

The position works closely with program leadership, financial analysts, and other stakeholders to ensure accurate, compliant, and data-informed decision-making in support of Medicaid managed care financial integrity.

Other Job Responsibilities:

+ Collaborate with agency staff on development of actuarially sound rates for MCOs and Dental Plans.

+ Analyze encounter data, premiums, claims trends, and administrative costs to support rate development.

+ Monitor and evaluate financial performance of managed care plans and identify potential risks.

+ Calculate and document outcomes related to risk corridors and Pay-for-Performance (P4P) benchmarks.

+ Prepare and present monthly and quarterly reports on MLR, risk corridor performance, and encounter data reconciliation.

+ Review and monitor Managed Care Financial Templates (F1/MRT) submitted by MCOs and Dental Plans.

+ Reconcile financial statements with encounter data and contractual requirements.

+ Assist in the development of managed care financial forecasts and multi-year budget models.

+ Align financial projections with operational goals and strategic initiatives.

+ Develop statistical models to predict cost and utilization trends for Medicaid populations.

+ Ensure rate development and financial reporting meet CMS and state audit standards.

+ Maintain accurate documentation for rate certifications, P4P outcomes, and actuarial analyses.

+ Respond to federal or state audit inquiries and support risk mitigation strategies.

+ Evaluate the financial terms of MCO and Dental Plan contracts and amendments.

+ Assess provider network financial performance and implications for rate setting.

+ Provide financial insights to support negotiations and contractual decisions.

+ Use financial and actuarial software (e.g., Excel, SAS, R, SQL) to manage, analyze, and report financial data.

+ Support ongoing improvements in Medicaid financial systems and processes.

+ Ensure integrity, completeness, and accuracy of data used in rate development and monitoring.

+ Present complex actuarial and financial findings to agency leadership, CMS, and legislative staff.

+ Provide financial expertise and consultation to Medicaid program staff and other internal partners.

+ Train and support staff on financial processes, systems, and methodologies as needed.

Benefits

Working for the State of Iowa comes with its perks. In addition to a competitive salary, you'll enjoy a comprehensive benefits package designed to support your well-being and professional growth:

+ Health, Dental, and Vision Coverage: Health and dental insurance packages to keep you and your family healthy at a low cost with outstanding coverage!

+ Paid Time Off: Take time to recharge with paid time off, including vacation (96 hours/year to begin, increasing with years of service), sick leave (144 hours/year), and paid holidays (9 days/year).

+ Retirement Plans: Participate in retirement plans such as IPERS (employees contribute 6.29% and the State of Iowa contributes 9.44%) as well as our Retirement Investors Club (RIC), Employer Sponsored Retirement Plan (the State of Iowa matches dollar for dollar up to $75/month).

+ Flexible Spending Accounts: Take advantage of flexible spending accounts for medical and dependent care expenses.

+ Insurance Coverage: Benefit from life insurance and free long-term disability insurance for added peace of mind.

+ Employee Assistance Program: Access resources and support through our Employee Assistance Program for personal and professional challenges.

+ Employee Discount Programs: Enjoy discounts on a variety of goods and services through our employee discount programs.

For additional information on benefits click here.

Click hereto see how we compare with other employers or offers by using our Total Compensation Calculator.

Background Checks

Applicants will be required to complete a background check to be considered for this position.

The State of Iowa is an EEO/AA Employer

HHS values those with “lived experience” and encourages adults who were fostered as youth, foster parents, and/or parents who were in the DHS system to apply. Minorities, women, persons with disabilities and veterans are encouraged to apply (Hearing and Speech Impaired – Relay Iowa 1-800-735-2942 TDD).

Our agency uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify

Minimum Qualification Requirements

Graduation from an accredited college or university with major coursework in mathematics, statistics, or actuarial science and the experience equal to three years of full-time work conducting actuarial studies;

OR

an equivalent combination of education and experience substituting the equivalent of one year of qualifying experience for each year of the required education to a maximum substitution of four years;

OR

graduate level coursework in actuarial science or statistics may be substituted for up to one year of the required experience on the basis of 30 semester hours equals one year of experience;

OR

completion of each part of the casualty or life actuarial examination may be substituted for three months of the required experience with a maximum substitution of one year.

For additional information, please click on thislink to view the job description. (https://das.iowa.gov/sites/default/files/hr/documents/class\_and\_pay/JobClassDescriptions/Actuary-00465.pdf)

Why Choose the State of Iowa?

At the heart of our commitment to excellence is a dedication to our most valuable asset – our employees. Discover the outstanding benefits that set us apart as an employer of choice.

Our Robust Benefits Package Includes:

Competitive Compensation:

Enjoy a competitive salary that reflects directly on your skills and expertise.

Keep in mind, your wage is just one part of your total compensation. Unlock the complete value of your employment with the State of Iowa by using our user-friendlyTotal Compensation Calculator (https://das.iowa.gov/media/3773/download?inline) .Gain insights into your comprehensive annual compensation, including salary and State-provided benefits.

Health and Wellness:

Prioritize your well-being with our comprehensive health plans, including medical, dental, and vision coverage. Enjoy the peace of mind knowing that the State of Iowa covers 90% of the premiums, providing you and your loved ones with excellent coverage at a remarkably low cost.

Retirement Planning:

We are proud to offer the Iowa Public Employees Retirement System (IPERS). A defined benefit plan, IPERS benefits are guaranteed for life, meaning once you retire, you will receive the same monthly benefit for the remainder of your life (once vested). We invest in your long-term financial well-being, so you can retire with peace of mind.Click here to learn more about IPERS (https://ipers.org/members) .

Paid Time Off:

Life is unpredictable, and at the State of Iowa, we understand the importance of work-life balance. Our leave policies, including paid holidays, vacation, and sick leave with unlimited accrual, ensure you have the flexibility you need for personal and family matters.

Professional Development:

Elevate your career with continuous learning opportunities. We support your growth through training programs, workshops, and tuition reimbursement.

Employee Assistance Program (EAP):

We care about your well-being beyond the workplace. Access confidential counseling, resources, and support through our Employee Assistance Program.

Diversity and Inclusion:

Be part of a diverse and inclusive workplace that embraces all backgrounds and perspectives. We believe diversity is a strength that drives innovation.

Join Us - Elevate Your Career:

Ready to elevate your career with the State of Iowa?Click here (https://iowa.attract.neogov.com/recruitment/p/benefits) to explore more about our unparalleled benefits and discover what makes us unique. Your success is our priority!

01

Do you understand that the answers to all of the following questions must be truthful, honest, and accurate to the best of your ability? Please read all questions and answers thoroughly and make sure you understand them completely.Ensure the answers to your questions match the information filled out on your application and the attachments you have uploaded. If the answers to your questions are inconsistent with your application information or uploaded attachments, you will be given zero points for the question.Knowingly misrepresenting the facts when submitting any information related to an application, examination, certification, appeal, or any other facet of the selection process will result in your disqualification from this application and future employment with the state of Iowa.

+ Yes - I understand and agree.

+ No

02

PLEASE READ CAREFULLY

Have you filed a registration statement pursuant to the federal Foreign Agents Registration Act of 1938, as amended, 22 U.S.C. §611 et seq?

+ No - I have NOT filed a registration statement pursuant to the federal Foreign Agents Registration Act of 1938, as amended, 22 U.S.C. §611 et seq

+ Yes - I HAVE filed a registration statement pursuant to the federal Foreign Agents Registration Act of 1938, as amended, 22 U.S.C. §611 et seq

03

Do you have a degree or have major course work in mathematics, statistics, or actuarial science? (You may attach a transcript to the application in the documents section.)

+ Yes

+ No

04

Describe applicable "actuarial" work experience from previous roles where you have done risk analysis or financial modeling/analysis? Please list employer, dates of employment, and specific description of actuarial work duties.

Required Question

Employer

State of Iowa

Agency

400 Health & Human Services - Medicaid

Address

Lucas State Office Building

321 E. 12th Street

Des Moines, iowa, 50319

Website

https://hhs.iowa.gov

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