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Humana Actuary, Pricing in Springfield, Missouri

Description

The Actuary, Pricing is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new plans and benefit changes. Provides guidance to Product Development on new product/benefit cost impacts. Develops and maintains pricing tools that price standard and custom benefits. The Actuary, Pricing works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

The Actuary, Pricing establishes market level financial metrics to align with segment profitability goals, analyzes market level results and projections and develops recommended pricing actions to address gaps to targeted metrics. Leverages market level projections and experience data tools to research root cause and capture insights. Researches and understands competitors in marketplace and collaborates with sales and other partners supporting the markets to develop strategies for profitable membership growth. Accountable for actuarial certifications on rate filings, including attesting to compliance with state and federal rating and benefit regulations. 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.

At Humana, the Market Risk Management Actuarial team is at the heart of executing on the strategic priorities for the Employer Group segment. Our teams drive business results by developing strategies and pricing actions at the market level to achieve profitability and membership targets. An Actuary on this team serves as a regional lead, manages a team of 1-3 actuaries, and oversees several Employer Group markets.

Key responsibilities for the Actuary include:

  • Oversee the actuarial functions for multiple EG markets

  • Manages and fosters development of 1-3 actuarial analysts

  • Be key contributor to expanding department's knowledge of market-level financials and ensuring reasonable projections, sharing best practices and tools developed

  • Build robust understanding of market dynamics, how to balance sales with profitability, and lead market growth strategies, initiatives, and decisions

  • Review and certification of rate filings

  • Determine and present rate recommendations to more senior leaders

  • Collaborate with key business partners to execute on growth and financial stability strategies and initiatives

  • Build strong relationship with market partners, supporting pricing questions and assisting in market strategies

  • Exercises independent judgement and decision making on complex issues regarding job duties and related tasks and work under minimal supervision with a high level autonomy

  • Prioritize work and manage multiple deadlines with minimal guidance

  • Exhibit a high level of ownership and accountability in core functions, financial results, and market strategies

  • Become sought after subject matter expert on multiple topics

  • Identify business issues and opportunities and harness expertise to develop analyses, solutions, and strategies

  • Understand the big picture and connection of our work to outcomes and goals for the company

Required Qualifications

  • Bachelor's Degree

  • FSA with one year of healthcare industry experience or ASA with 3 years of healthcare industry experience

  • MAAA

  • Demonstrated ability to communicate with other business areas

  • Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)

Preferred Qualifications

  • Proficiency in Excel, VBA, SQL

  • Experience working with the markets or sales in Commercial or Medicare environments

  • Interest in leading actuarial students

  • Ability to collaborate and build relationships with non-actuarial business partners

  • Rate filing experience

  • Presentation skills or strong desire to practice presentation skills

  • Collaborator and team-player

  • Strong time and project management skills

Additional

Scheduled Weekly Hours

40

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