Actuary, Medicaid Pricing
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Chicago, IL 60684
The Actuary, Medicaid Pricing provides actuarial support across a broad range of actuarial and business needs for specific product lines. The Actuary, General works on problems of diverse scope and complexity ranging from moderate to substantial.
The Actuary, Medicaid Pricing may be responsible for any combination of valuation, pricing, analytics, forecasting, risk, compliance, and operations. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
+ Act as the financial steward of the Medicaid business by timely reporting key financial metrics to leadership and proactively seeking opportunities to enhance profitability.
+ Develop, maintain, and enhance Humana’s Medicaid reporting and modeling capabilities.
+ Work with state Medicaid agencies, state health plan associations, and their respective actuarial consultants to influence rate setting and meet compliance goals.
+ Develop financial projections, rate adequacy analysis, risk adjustment analysis, trend studies, and population studies for the Medicaid business.
+ Provide assistance in responding to state Medicaid RFPs (Request for Proposal).
+ Provide leadership in cross departmental initiatives to enhance Medicaid profitability.
+ Potential to manage small staff of actuarial students
+ 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)Typically requires a Bachelor’s degree and 8+ years of technical experience, or equivalent and 2+ years of project leadership experience
+ Experience with SAS
+ Medicaid exp
This role can be located in Louisville, KY, Mkt offices or WAH
Scheduled Weekly Hours
Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms -when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
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