[Remote] Actuary, Pricing at Humana

San Antonio, Texas, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, 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 skills
Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)
Passionate about contributing to an organization focused on continuously improving consumer experiences

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
Developing recommended pricing actions to address gaps to targeted metrics
Leveraging market level projections and experience data tools to research root cause and capture insights
Researching and understanding competitors in marketplace
Collaborating 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
Advising executives to develop functional strategies (often segment specific) on matters of significance
Exercising independent judgment and decision making on complex issues regarding job duties and related tasks, working under minimal supervision

Skills

Key technologies and capabilities for this role

Actuarial PricingRate FilingPricing AssumptionsPremium RatesRegulatory ComplianceFinancial ModelingMarket AnalysisCompetitor ResearchPricing ToolsActuarial CertificationFSAASAMAAA

Questions & Answers

Common questions about this position

What is the salary range for the Actuary, Pricing 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.

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?

A Bachelor's Degree is required, along with FSA or ASA plus relevant advanced degree or experience, MAAA, strong communication skills, and experience in more than two actuarial functions like modeling, pricing, or rate filing.

Is there a bonus or incentive plan for this position?

Yes, this job is eligible for a bonus incentive plan based on company and/or individual performance.

What preferred qualifications will make me stand out for this role?

Medicare Advantage experience, strong communication skills, and the ability to manage large projects involving actuarial and non-actuarial staff are preferred.

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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