Actuary, Pricing - Individual MA

Humana

3d•$129,300 - $177,800•Remote

About The Position

The Actuary, Pricing develops and executes 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 role establishes market-level financial metrics aligned with segment profitability goals; analyzes results and projections; and recommends pricing actions to address performance gaps. It manages forecasting cycles in accordance with government-established timelines and uses market projections and experience-data tools to identify root causes and develop actionable insights. The Actuary, Pricing monitors the competitive landscape and collaborates with market partners to develop 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. It also advises executives on significant, often segment-specific functional strategies. This is a remote position with 40 scheduled weekly hours. The employee must accommodate a work schedule aligned with the Eastern Time Zone. Occasional travel to Humana offices for training or meetings may be required. Employees working from home must have internet service with at least 25 Mbps download and 10 Mbps upload speeds and a dedicated workspace that prevents ongoing interruptions and protects member PHI/HIPAA information.

Requirements

Bachelor's degree.
FSA or ASA, plus a relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations.
MAAA.
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 aligned with the Eastern Time Zone.
For work from home: self-provided internet service with at least 25 Mbps download and 10 Mbps upload speeds, and a dedicated workspace 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 tools for pricing 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 functional strategies, often specific to a segment.