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Chicago, IL 60684
The Actuary, Analytics/Forecasting analyzes and forecasts authorization and clinical metrics understanding impacts from operational decisions and industry trends. Establishes metrics, provides data analyses, and works directly with key parties to support business intelligence. Evaluates authorizations, claims and market trends to evaluate short, medium and long-term financial impacts due to organizational initiatives. The Actuary, Analytics/Forecasting works on problems of diverse scope and complexity ranging from moderate to substantial.
The Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and understand data anomalies. 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.
The Actuary will use information from clinical to understand the authorization process and use this understanding to analyze impacts due to operational metrics or industry changes. This person will work closely with the markets and clinical space as well as present finding to leadership.
+ 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 with Authorization data or Claims data
+ Experience with coding in SAS
+ Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)
+ Management Experience
+ Experience with both health claims and authorization data
+ Skills with communicating to broad audiences
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.
Equal Opportunity Employer
It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.
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