Chief Strategy Officer

Dept of Health and Human Services

HEALTH BENEFITS

Health & Human Services Senior Planner (NS)

65023625

31002876

The Chief Strategy Officer position serves as the Chief Actuary for the Division of Health Benefits (DHB) and provides executive-level leadership, oversight, and strategic direction for actuarial services supporting North Carolina Medicaid programs. The position is responsible for directing rate development, financial forecasting, budgeting, risk analysis, policy evaluation, and actuarial modeling to support Medicaid managed care, Medicaid Transformation initiatives, and implementation of federal waiver programs.

Responsibilities include managing complex actuarial and financial analyses, advising executive leadership on payment strategies and program impacts, overseeing relationships with federal partners and stakeholders, and ensuring compliance with state and federal requirements. This position collaborates with senior leaders, policymakers, healthcare providers, managed care organizations, consultants, and government officials to support data-driven decision-making and the effective administration of healthcare services for North Carolina residents.


Key Duties Include:
- Direct actuarial operations supporting Medicaid managed care, including capitation rate development, pricing strategies, rate negotiations, claim reserving, forecasting, budgeting, and financial analysis.

- Lead the development and implementation of actuarial methodologies, financial models, assumptions, and analytic frameworks used to support program planning, healthcare financing, and policy decision-making.

- Oversee the analysis of healthcare cost, utilization, and reimbursement trends and develop recommendations to support benefit design, reimbursement standards, and payment strategies.

- Direct financial and actuarial analyses related to Medicaid Transformation initiatives, Section 1115 waiver implementation, budget neutrality requirements, and Medicaid expansion populations.

- Establish actuarial standards, analytical processes, and quality control measures to ensure accuracy, consistency, regulatory compliance, and adoption of industry best practices.

- Identify, evaluate, and communicate financial risks associated with healthcare delivery, policy changes, legislative initiatives, market trends, and program operations and develop strategies to mitigate identified risks.

- Oversee predictive modeling, risk adjustment activities, financial forecasting, and enterprise-wide analytical initiatives used to support operational and strategic decision-making.

- Provide executive-level consultation and strategic recommendations to DHB leadership, the DHHS Secretary’s Office, the Governor’s Office, state policymakers, and other stakeholders regarding actuarial, financial, and healthcare policy matters.

- Manage relationships with federal partners, including the Centers for Medicare & Medicaid Services (CMS), and support negotiations related to waivers, financing arrangements, and program authorities necessary to achieve Medicaid program objectives.

- Direct the work of actuarial staff, consultants, contractors, and business partners while promoting collaboration, performance management, continuous improvement, and achievement of division goals and objectives.

- Collaborate with healthcare providers, managed care entities, advocacy organizations, legislators, and other stakeholders to evaluate program performance, develop policy solutions, and support effective healthcare delivery systems.

- Prepare and present actuarial findings, financial forecasts, rate recommendations, strategic analyses, and executive reports to support program oversight, financial stewardship, and organizational decision-making.

- Monitor healthcare industry trends, emerging actuarial practices, regulatory developments, and innovative analytical approaches to strengthen program performance and support long-term sustainability of North Carolina Medicaid programs.

- Support the division’s mission, strategic priorities, and statewide values through leadership, accountability, customer service, teamwork, and data-driven decision-making.

- Perform other related duties and special projects as assigned.

Some state job postings say you can qualify by an “equivalent combination of education and experience.” If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See the Education and Experience Equivalency Guide for details.

Graduation from a four year college or university with a degree in business or public administration or in a field related to DHHS programs, and five years of managerial and/or administrative experience in the public or private sectors involving significant decision-making authority in the planning, organizing, and directing in an area related to the above-mentioned programs; or an equivalent combination of training and experience.

Tresha Walker