Actuarial Director - Medicaid Pricing

Humana

2d • Remote

About The Position

Become a part of our caring community The Director, Actuarial of Medicaid Pricing provides actuarial support across a broad range of actuarial and business needs for specific product lines. You will require an in-depth understanding of how organization capabilities interrelate across the function or segment. The Director, Actuarial of Medicaid Pricing will report to the Associate VP, Lead Medicaid Actuary. Key Responsibilities: 1. Rate Advocacy Lead proactive rate advocacy efforts across assigned Medicaid markets Identify gaps between emerging experience vs. state rate assumptions Develop clear, evidence-based narratives to support rate adequacy discussions with state actuaries and regulators Partner with market CFOs and leadership to align on advocacy posture, trade-offs, and priorities Drive earlier engagement with states prior to draft rate development Represent the organization in external forums 2. Financial Insight & Risk Identification Translate financial results into actionable insights Support reforecast cycles with clear articulation of financial drivers Identify opportunities to improve financial outcomes in maturing markets 3. Market Partnership Serve as the actuarial thought partner to market leadership, finance, and clinical teams Collaborate with Finance, Health Care Economics, market operation teams 4. Team Leadership Lead and develop a team of actuaries; coach toward strategic thinking and storytelling Standardize approaches to rate review, communication, and escalation of risks Use your skills to make an impact

Requirements

• Bachelor's degree
• 7 or more years of actuarial experience
• Deep experience with Medicaid rate setting or state actuarial processes
• Experience working directly with state agencies or consulting on Medicaid rates
• 5 or more years of management experience
• FSA or ASA MAAA
• Experience in more than three functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)

Nice To Haves

• Track record of leading cross-functional initiatives and influencing without authority
• Demonstrated leadership capability, has led sizable staff before
• Experience in leading other human capital leaders

Responsibilities

• Rate Advocacy Lead proactive rate advocacy efforts across assigned Medicaid markets
• Identify gaps between emerging experience vs. state rate assumptions
• Develop clear, evidence-based narratives to support rate adequacy discussions with state actuaries and regulators
• Partner with market CFOs and leadership to align on advocacy posture, trade-offs, and priorities
• Drive earlier engagement with states prior to draft rate development
• Represent the organization in external forums
• Translate financial results into actionable insights
• Support reforecast cycles with clear articulation of financial drivers
• Identify opportunities to improve financial outcomes in maturing markets
• Serve as the actuarial thought partner to market leadership, finance, and clinical teams
• Collaborate with Finance, Health Care Economics, market operation teams
• Lead and develop a team of actuaries; coach toward strategic thinking and storytelling
• Standardize approaches to rate review, communication, and escalation of risks

Benefits

• Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Director