[Remote] Actuarial Analyst, Pricing at Humana

San Antonio, Texas, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor's Degree
Successful completion of at least 3 actuarial exams
Strong communication skills
Passionate about contributing to an organization focused on continuously improving consumer experiences
Experience with SQL or VBAM (Preferred)
Medicare experience (Preferred)

Responsibilities

Setting pricing assumptions
Submitting bids
Filing and gaining approval of premium rates and rate certifications with regulatory agencies
Supporting implementation of rates, new plans, and benefit changes
Providing guidance to Product Development on new product/benefit cost impacts
Developing and maintaining pricing tools that price standard and custom benefits
Establishing market-level financial metrics to align with segment profitability goals
Analyzing market-level results and projections and developing recommended pricing actions
Leveraging market-level projections and experience data tools to research root cause and capture insights
Researches and understands competitors in marketplace and collaborates with sales and other partners supporting the markets to develop strategies for profitable membership growth
Accountable for actuarial certifications on rate filings, including attesting to compliance with state and federal rating and benefit regulations
Understanding department, segment, and organizational strategy and operating objectives
Making decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction
Following established guidelines/procedures

Skills

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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