Associate Director, Medicaid Trend

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

Health InsuranceIndustries

Requirements

Candidates must possess a Bachelor's Degree and be an FSA or ASA with at least 5 years of actuarial experience in health insurance. Strong communication skills and experience in multiple actuarial functions and products are required. Medicaid and trend/healthcare analytics experience are preferred, as is proficiency in data analysis using statistical programming languages like SAS, Databricks, SQL, or Python.

Responsibilities

The Associate Director, Actuarial Analytics/Forecasting will analyze and forecast financial, economic, and other data to support strategic decisions. This role involves establishing metrics, conducting data analyses, evaluating trends, and ensuring data integrity through process development and controls. The position leads a team responsible for ROI analyses of operational initiatives, creating actuarial evaluations of savings opportunities, communicating results to senior leaders, and meeting with vendors to assess their value.

Skills

Actuarial Analytics

Forecasting

Financial Analysis

Economic Analysis

Data Analysis

Business Intelligence

ROI Analysis

Health Insurance

Modeling

Pricing

Rate Filing

Reporting

Communication 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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