Actuary, Medicaid Trend Analytics, Data Management

November 21

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Humana

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Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

10,000+ employees

Founded 1961

⚕️ Healthcare Insurance

📋 Description

• Own and manage Medicaid claims analytics dataset using Databricks. • Ensure data accuracy, completeness, and readiness to support modeling, reporting, and decision-making. • Requires strong project management skills to evaluate the downstream impacts of data changes on actuarial models, reporting tools, and financial results. • Lead and manage data-related projects from scoping through post-production validation, partnering with teammates to implement data transformations, automation, and enhancements. • Conduct in-depth analysis of healthcare claims to identify data issues and optimization opportunities. • Work with actuarial, financial, and clinical teams to assess and determine optimal data solutions. • Provide strategic recommendations on data architecture and improvements. • Support team in identification of cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. • The Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. • This role collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies.

🎯 Requirements

• Bachelor's Degree • FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations. • MAAA • Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending) • Demonstrated project management skills with the ability to drive work independently and effectively lead through collaboration • Experience in managing large healthcare claim datasets and conducting trend analysis • Advanced knowledge of Databricks, SQL, or Python

🏖️ Benefits

• medical, dental and vision benefits • 401(k) retirement savings plan • time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave) • short-term and long-term disability • life insurance