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Humana

Sells Medicare health plans and runs senior clinics

Lead Actuary

Actuarial & Risk ModellingPosted on Nov 12
Full-timeRemote in USA

About the Job

Requirements

  • A bachelor's degree is required.
  • FSA or ASA, together with a relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations, is required.
  • MAAA is required.
  • Ability to articulate ideas effectively in written and oral forms is required.
  • Experience in more than two functions, such as modeling, pricing, rate filing, reporting and analysis, reserving, or trending, is required.

Responsibilities

  • Set pricing assumptions; submit bids; file and obtain 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 develop recommended pricing actions to address gaps to targeted metrics.
  • Use market-level projections and experience-data tools to research root causes and capture insights.
  • Support actuarial certifications on rate filings, including attesting to compliance with state and federal rating and benefit regulations.
  • Advise executives in developing functional strategies, often segment-specific, on matters of significance.
  • Exercise independent judgment and decision-making on complex issues and related tasks, analyzing variable factors to determine the best course of action.

Desired Qualifications

  • Experience in Medicare Advantage (MA).
  • Knowledge of pricing basics.
  • Prior leadership experience.

About the Company

Humana

Sells Medicare health plans and runs senior clinics

Humana sells health insurance paid for by government programs, chiefly Medicare Advantage plans that private insurers run for Americans 65 and older in place of traditional Medicare. It ranks among the largest Medicare Advantage insurers in the country and also runs Medicaid plans for low-income families in several states. Its CenterWell business operates senior primary care clinics, a mail-order pharmacy and home health services, so many members get care from a company the insurer owns. Medicare and states pay Humana a set monthly amount per member, and it keeps the difference between those payments and members' medical costs. Humana was founded in 1961 as a nursing home company and is based in Louisville, Kentucky.

Company size
10,001+
Company stage
IPO
Headquarters
Louisville, KY
Founded
1961

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