Actuary, Pricing - Individual MA

Humana

3d•$129,300 - $177,800•Remote

About The Position

The Actuary, Pricing will develop and execute pricing strategies for Medicare Advantage products. The role establishes pricing assumptions, prepares and submits bids, supports regulatory rate filings and certifications, and helps implement rates, new plans, and benefit changes. It advises Product Development on the cost impact of new products and benefits and develops and maintains tools for pricing standard and customized offerings. The position addresses moderately to highly complex actuarial challenges and requires analytical judgment and cross-functional collaboration. Reporting to the Director, Actuarial Pricing, the Actuary establishes market-level financial metrics aligned with segment profitability goals, analyzes results and projections, and recommends pricing actions to address performance gaps. The role manages forecasting cycles aligned with government timelines, uses market projections and experience-data tools to identify root causes, and develops actionable insights. The Actuary monitors the competitive landscape and collaborates with market partners on strategies for profitable membership growth. The role is accountable for actuarial certifications related to rate filings, including attesting to compliance with state and federal rating and benefit regulations, and advises executives on significant, often segment-specific, functional strategies.

Requirements

Bachelor's degree.
FSA or ASA plus a relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations.
MAAA.
Demonstrated ability to articulate ideas effectively in written and oral forms.
Experience in more than two functions, such as modeling, pricing, rate filing, reporting and analysis, reserving, or trending.
Willingness to accommodate a work schedule according to the Eastern Time Zone.
For home work, access to internet service with at least 25 Mbps download and 10 Mbps upload speed; wireless, wired cable, or DSL connection is suggested.
For home work, a dedicated space without ongoing interruptions to protect member PHI/HIPAA information.

Nice To Haves

Recent experience with Medicare Advantage bid filing.
Experience as a people leader.

Responsibilities

Develop and execute pricing strategies for Medicare Advantage products.
Establish pricing assumptions and prepare and submit bids.
Support regulatory rate filings and certifications, and help implement rates, new plans, and benefit changes.
Advise Product Development on the cost impact of new products and benefits.
Develop and maintain pricing tools for standard and customized offerings.
Establish market-level financial metrics aligned with segment profitability goals.
Analyze results and projections and recommend pricing actions to address gaps in targeted performance.
Manage forecasting cycles aligned with government-established timelines.
Use market projections and experience-data tools to identify root causes and develop actionable insights.
Monitor the competitive landscape and collaborate with market partners on strategies that support profitable membership growth.
Provide actuarial certifications related to rate filings, including attesting to compliance with state and federal rating and benefit regulations.
Advise executives on significant, often segment-specific functional strategies.