***Please note that a resume will not be accepted nor reviewed to determine if an applicant has met the qualifications for the position. All applicants must apply online at careers.sc.gov to be considered for employment. We look forward to receiving your application!***

Are you the One?  We are looking for an Actuary, who will provide consultation for the Medicaid Director and Deputy Director of Finance and Administration. This includes recommending policies on reimbursement methodologies that impact on programs, services, and other governmental and private sector entities with expenditures at almost 7 billion Medicaid dollars each year.

• Utilizes federal and state regulations, rules and laws, recommends policies, objectives and priorities as it relates to reimbursement and methodologies and rates. Oversees the development of Medicaid reimbursement rates and establishes Medicaid reimbursement policy and methodologies for institutional and non-institutional providers which contract/enroll with the South Carolina Medicaid Program. Advises the Agency Director and Deputy Directors on all issues relating to Medicaid payment/reimbursement policy changes and funding issues. Develops and advises on value-based Medicaid payment policies that drive sustainable reform. Conducts research and analysis of Medicaid reimbursement rates and reimbursement policies for actuarial soundness to ensure efficiency and to monitor budgetary constraints by actions relating to South Carolina Medicaid reimbursement policy and funding issues. Ensures compliance with numerous federal and state laws and regulations as well as generally accepted accounting principles when developing all Medicaid reimbursement policies and methodologies.
• Collects, compiles and analyzes statistical data by developing spreadsheets, databases and statistical models related to Medicaid to distribute to Agency Director, Deputy Directors, state and federal agencies, and provider organizations.
• Identifies risk, including economic and financial trends as it relates to Medicaid reimbursement. Performs actuarial, economic, and demographic studies to estimate Medicaid reimbursement rates.
• Design, test, and evaluate policies to determine if Medicaid reimbursement procedures are actuarial sound and to ensure efficiency and identify trends.
• Prepares and presents plans and proposals relating to Medicaid reimbursement policy to the agency director, state, and federal agencies, federal and state legislative staff, and provider organizations.
• Publishes cost projections and economic analyses, and provide actuarial, technical advice and consultation to state and federal components.
• Oversees the development, submission and implementation of Medicaid reimbursement methodology policy into the South Carolina Medicaid State Plan. Reviews all programmatic and reimbursement related state plan amendments to ensure compliance with federal regulations.
• Performs fundamental supervisory functions in accordance with Equal Employment Opportunity Commission (EEOC) standards. Provides leadership by effectively organizing and developing staff in the Office of Reimbursement Methodologies. Directs managerial staff with the Reimbursement Division in administering policies achieving objectives and accomplishing goals and priorities in accordance with the vision of agency executive staff.

• Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.
• 15 days annual (vacation) leave per year.
• 15 days sick leave per year.
• 13 paid holidays.
• State Retirement Plan and Deferred Compensation Programs.