Associate Actuary - Medicaid Trend

San Antonio, Texas, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Requirements

Candidates must possess a Bachelor's degree in Actuarial Science, Mathematics, Statistics, or a related field, and hold an ASA or FSA designation with MAAA. A minimum of 2 years of actuarial experience in health insurance and/or medical claims analytics is required, along with proficiency in data analysis and at least one statistical programming language such as SAS, Databricks, SQL, or Python. Experience in building, monitoring, and enhancing complex actuarial models is also necessary.

Responsibilities

The Associate Actuary will evaluate economic, financial, and market trends to forecast the organization's financial position and prepare trend analytics for strategic decision-making. This role involves developing, monitoring, and communicating cost trend drivers, utilization patterns, and economic insights for Humana's Medicaid markets, focusing on non-inpatient analytics. Responsibilities include enhancing actuarial models, developing new tools, creating, modifying, and reviewing logic in coding platforms, collaborating with stakeholders to develop analytic solutions, troubleshooting data anomalies, conducting actuarial modeling, and presenting trend drivers to leadership.

Skills

Actuarial modeling

Healthcare data analysis

Trend analytics

Cost trend drivers

Utilization patterns

Economic insights

Coding platforms

Data anomalies

Strategic decision-making

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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