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, an Associate of Society of Actuaries (ASA) designation, and MAAA accreditation. Strong communication and technical skills are essential, along with a passion for improving consumer experiences. Medicaid experience, SAS/SQL, Databricks, and Microsoft Office suite proficiency are preferred qualifications, as is prior ROI/evaluation work.

Responsibilities

The Associate Actuary will ensure data integrity through process development and controls, troubleshoot data anomalies, and conduct root cause analysis. This role involves performing ROI/evaluation analyses for vendor relationships and internal initiatives to reduce costs and improve member health outcomes within Humana's Medicaid business. Responsibilities include critically measuring value, clearly communicating analysis results, and managing time effectively.

Skills

Data Integrity

Data Flow

Problem Solving

Root Cause Analysis

ROI Analysis

Value Measurement

Communication

Technical Skills

Time Management

Organization

SAS

SQL

Databricks

Microsoft Office Suite

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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