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Actuary, Medicaid Pricing

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Job Details
Job Order Number
JC153550761
Company Name
Humana
Physical Address

Portland, ME 04104
Job Description

Description

The Actuary, Medicaid Pricing provides actuarial support across a broad range of actuarial and business needs for specific product lines. The Actuary, General works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

The Actuary, Medicaid Pricing may be responsible for any combination of valuation, pricing, analytics, forecasting, risk, compliance, and operations. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.

Responsibilities include:

+ Act as the financial steward of the Medicaid business by timely reporting key financial metrics to leadership and proactively seeking opportunities to enhance profitability.

+ Develop, maintain, and enhance Humana’s Medicaid reporting and modeling capabilities.

+ Work with state Medicaid agencies, state health plan associations, and their respective actuarial consultants to influence rate setting and meet compliance goals.

+ Develop financial projections, rate adequacy analysis, risk adjustment analysis, trend studies, and population studies for the Medicaid business.

+ Provide assistance in responding to state Medicaid RFPs (Request for Proposal).

+ Provide leadership in cross departmental initiatives to enhance Medicaid profitability.

+ Potential to manage small staff of actuarial students

Required Qualifications

+ Bachelor’s Degree

+ FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations.

+ MAAA

+ Strong communication skills

+ Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)Typically requires a Bachelor’s degree and 8+ years of technical experience, or equivalent and 2+ years of project leadership experience

Preferred Qualifications

+ Experience with SAS

+ Medicaid exp

Additional Information

This role can be located in Louisville, KY, Mkt offices or WAH

Scheduled Weekly Hours

40

About Us

Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms -when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

Equal Opportunity Employer

It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.

If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailbox_tas_recruit@humana.com for assistance.

Humana Safety and Security

Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailbox_tas_recruit@humana.com to validate the request.


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