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Associate Actuarial Director - Individual Medicare Advantage

Role overview

Qualifications

  • Bachelors Degree
  • 5 or more years of experience in Medicare Advantage bid filing
  • FSA or ASA or MAAA
  • Demonstrated ability to articulate ideas effectively in both written and oral forms

Responsibilities

  • Set pricing assumptions, submit bids, and file for premium rates and rate certifications
  • Develop and maintain pricing tools for standard and custom benefits
  • Analyze market level results and develop recommended pricing actions
  • Lead 2-3 Medicare Advantage regions and manage 2-3 direct reports

Key facts

Hard skills

Other skills

  • Leadership
  • Communication
  • Teamwork
  • Analytical Thinking

About the company

Humana logo

Humana

Health Insurance (Payers)

At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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Job description

Become a part of our caring community
 

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.


Use your skills to make an impact
 

Role Essentials

  • 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

Role Desirables

  • Masters degree

  • Demonstrated leadership capability, has led sizable staff before

  • Experience in leading other human capital leaders

Additional Information

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

  • Satellite, cellular and microwave connection can be used only if approved by leadership

  • Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

  • Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$156,600 - $215,400 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and 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 and many other opportunities.Application Deadline: 10-11-2026


About us
 

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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Marcus Rivera

Chief Revenue Officer

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