[Remote] Actuary, 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
FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations
Strong communication skills
Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)
Passion for contributing to an organization focused on continuously improving consumer experiences
Medicare Advantage experience (preferred)
Strong Communication Skills (preferred)

Responsibilities

Set pricing assumptions, submit bids, 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/benefit cost impacts
Develop and maintain pricing tools that price standard and custom benefits
Establish market level financial metrics to align with segment profitability goals
Analyze market level results and projections and develop recommended pricing actions to address gaps to targeted metrics
Research and understand competitors in the marketplace and collaborate with sales and other partners to develop strategies for profitable membership growth
Account for actuarial certifications on rate filings, including attesting to compliance with state and federal rating and benefit regulations
Advise executives to develop functional strategies (often segment specific) on matters of significance
Exercise independent judgment and decision making on complex issues regarding job duties and related tasks

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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