Associate Actuarial Director - Individual Medicare Advantage

Humana

3d • $156,600 - $215,400 • Remote

About The Position

The Associate Director, Actuarial 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 Associate Director, Actuarial Pricing requires a solid understanding of how organization capabilities interrelate across department(s).
The Associate Director, Actuarial 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 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.
The Associate Director, Actuarial Pricing will:
Lead 2-3 Medicare Advantage regions
Responsible for reviewing individual MA bids for accuracy and compliance.
Support recurring forecasts and providing financial guidance to leadership.
Participate in cross functional work groups.
Manages 2-3 direct reports with total team size of 4-7 associates.

Requirements

• Bachelors Degree
• 5 or more years of experience in Medicare Advantage bid filing
• FSA or ASA or MAAA
• Experience in more than three functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending) and more than one product
• Demonstrated ability to articulate ideas effectively in both written and oral forms
• Self-provided internet service with at minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps; wireless, wired cable or DSL connection is suggested
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Nice To Haves

• Masters degree
• Demonstrated leadership capability, has led sizable staff before
• Experience in leading other human capital leaders

Responsibilities

• Setting pricing assumptions
• Submitting bids
• Filing and gaining approval of premium rates and rate certifications with regulatory agencies
• Supporting implementation of rates, new plans and benefit changes
• Providing guidance to Product Development on new product/benefit cost impacts
• Developing and maintaining pricing tools that price standard and custom benefits
• Establishing market level financial metrics to align with segment profitability goals
• Analyzing market level results and projections
• Developing recommended pricing actions to address gaps to targeted metrics
• Leveraging market level projections and experience data tools to research root cause and capture insights
• Researching and understanding competitors in marketplace
• Collaborating with partners supporting the markets to develop strategies for profitable membership growth
• Actuarial certifications on rate filings, including attesting to compliance with state and federal rating and benefit regulations
• Lead 2-3 Medicare Advantage regions
• Reviewing individual MA bids for accuracy and compliance
• Support recurring forecasts and providing financial guidance to leadership
• Participate in cross functional work groups
• Manages 2-3 direct reports with total team size of 4-7 associates

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance
• bi-weekly payment for internet expense (for employees in California, Illinois, Montana, or South Dakota)
• telephone equipment appropriate to meet the business requirements for their position/job

What This Job Offers

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