Associate Actuarial Director – Individual Medicare Advantage

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🔥 1 minute ago

🇺🇸 United States – Remote

💵 $156.6k - $215.4k / year

⏰ Full Time

🔴 Lead

📊 Actuary

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • 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.

📋 Description

• Set pricing assumptions, submit bids, and file and gain approval of premium rates and rate certifications with regulatory agencies • Support implementation of rates, new plans, and benefit changes • Provide guidance to Product Development on new product and benefit cost impacts • Develop and maintain pricing tools for standard and custom benefits • Establish market-level financial metrics aligned with segment profitability goals • Analyze market-level results and projections and recommend pricing actions • Research root causes using market-level projections and experience data tools • Research competitors and collaborate with market partners on profitable membership growth strategies • Provide actuarial certifications on rate filings and attest to compliance with state and federal rating and benefit regulations • Lead 2–3 Medicare Advantage regions • Review individual Medicare Advantage bids for accuracy and compliance • Support recurring forecasts and provide financial guidance to leadership • Participate in cross-functional work groups • Manage 2–3 direct reports and a total team of 4–7 associates

🎯 Requirements

• Bachelor’s degree • 5 or more years of experience in Medicare Advantage bid filing • FSA, ASA, or MAAA • Experience in more than three functions, such as modeling, pricing, rate filing, reporting and analysis, reserving, or trending • Experience with more than one product • Ability to articulate ideas effectively in written and oral forms • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information • Home internet with at least 25 Mbps download and 10 Mbps upload speed • Willingness and ability to occasionally travel to Humana offices for training or meetings

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Internet expense payment for employees who live and work from home in California, Illinois, Montana, or South Dakota • Telephone equipment appropriate to business requirements • Remote work arrangement • Occasional travel to Humana offices for training or meetings