Associate Actuary, Pricing

Humana

22h • $106,900 - $147,000 • Remote

About The Position

The Associate Actuary, Pricing is responsible for setting pricing assumptions to support Medicare Part D bids. You will provide guidance to Product Development on new product/benefit cost impacts. You will develop and maintain pricing tools that price standard and custom benefits. The Associate Actuary, Pricing develops and maintains projections of drug utilization trends for Humana's Medicare Part D products to support pricing, forecasting, bid development, and strategic decision-making. Analyzes historical claims experience, emerging utilization patterns, member behavior, and market dynamics to identify key drivers of pharmacy cost trends and forecast future utilization at the drug, therapeutic class, and product levels. Leverages actuarial models, experience studies, and analytical tools to research root causes of utilization changes and capture actionable insights. Collaborates with pricing, forecasting, clinical, pharmacy, formulary, and finance teams to ensure utilization assumptions appropriately reflect emerging experience, operational initiatives, and industry developments. Monitors external factors, including new drug launches, loss of exclusivity events, clinical guideline changes, and regulatory impacts, to assess their influence on future utilization patterns. Communicates findings and recommendations to business partners and leadership, supporting sound forecasting and strategic planning decisions. Begins to influence department strategy through subject matter expertise in Medicare Part D utilization trends.

Requirements

• Bachelor's Degree
• Associate of Society of Actuaries (ASA) designation
• MAAA
• Excellent communication and interpersonal skills including the ability to translate complex topics to both technical and non-technical audiences
• Strong analytical skills

Nice To Haves

• Three or more years of Pricing, Medicare and/or Part D experience
• SAS/SQL/R/Databricks programming experience
• Experience with Power BI dashboards
• Experience with model building, exploratory analysis, and/or developing dashboards
• Highly motivated and willing to learn

Responsibilities

• Setting pricing assumptions to support Medicare Part D bids.
• Providing guidance to Product Development on new product/benefit cost impacts.
• Developing and maintaining pricing tools that price standard and custom benefits.
• Developing and maintaining projections of drug utilization trends for Humana's Medicare Part D products to support pricing, forecasting, bid development, and strategic decision-making.
• Analyzing historical claims experience, emerging utilization patterns, member behavior, and market dynamics to identify key drivers of pharmacy cost trends and forecast future utilization at the drug, therapeutic class, and product levels.
• Leveraging actuarial models, experience studies, and analytical tools to research root causes of utilization changes and capture actionable insights.
• Collaborating with pricing, forecasting, clinical, pharmacy, formulary, and finance teams to ensure utilization assumptions appropriately reflect emerging experience, operational initiatives, and industry developments.
• Monitoring external factors, including new drug launches, loss of exclusivity events, clinical guideline changes, and regulatory impacts, to assess their influence on future utilization patterns.
• Communicating findings and recommendations to business partners and leadership, supporting sound forecasting and strategic planning decisions.
• Influencing department strategy through subject matter expertise in Medicare Part D utilization trends.

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

What This Job Offers

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