[Remote] Actuary, ESRD Forecasting and Analytics at Humana

San Antonio, Texas, United States

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Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Requirements

Bachelor's Degree
FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations
MAAA
Strong communication and organizational skills
Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)

Responsibilities

Analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions
Establishes metrics, provides data analyses, and works directly to support business intelligence
Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position
Ensures data integrity by developing and executing necessary processes and controls around the flow of data
Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies
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
Owns and improves ESRD claims forecast process
Reviews input assumptions and outputs of the ESRD forecast for reasonability and accuracy
Summarizes and explains ESRD forecast results for business partners
Reviews and analyzes emerging experience on ESRD members to understand drivers of change and any potential headwinds or tailwinds

Skills

Key technologies and capabilities for this role

Actuarial ScienceForecastingAnalyticsData AnalysisClaims ForecastingESRDMedicare AdvantageRoot Cause AnalysisFinancial ModelingBusiness IntelligenceData IntegrityStatistical Analysis

Questions & Answers

Common questions about this position

What is the salary range for this Actuary position?

The pay range is $129,300 - $177,800 per year for full-time employment, and individual pay will vary based on skills, experience, and location. This job is eligible for a bonus incentive plan.

Is this a remote position, and is travel required?

This is a remote position, but occasional travel to Humana's offices for training or meetings may be required.

What are the required qualifications and skills for this role?

Candidates need a Bachelor's Degree, FSA or ASA plus relevant advanced degree or experience, MAAA, strong communication and organizational skills, and experience in more than two functions like modeling, pricing, or reserving.

What preferred skills are mentioned for this Actuary role?

Preferred qualifications include strong technical skills in SQL, VBA, and Databricks/Python, experience in Individual Medicare Advantage, and knowledge of the ESRD population.

What makes a strong candidate for this ESRD Forecasting Actuary position?

A strong candidate will be a subject matter expert on ESRD for Medicare Advantage plans, with FSA/ASA, MAAA, experience across actuarial functions, and technical skills like SQL and Python to own and improve ESRD claims forecasting.

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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