Actuarial Director of Medicaid Pricing

4 weeks ago

GondrecourtleChâteau, Grand Est, United States Humana Full time
Job Title: Director, Actuarial of Medicaid Pricing

Humana is seeking a highly skilled and experienced Director, Actuarial of Medicaid Pricing to join our team.

About the Role:

The Director, Actuarial of Medicaid Pricing will provide actuarial support across a broad range of actuarial and business needs for specific product lines. This role requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

Key Responsibilities:
  • Provide actuarial support for valuation, pricing, analytics, forecasting, risk, compliance, and operations.
  • Develop and implement strategic plans to drive goals and objectives.
  • Improve performance and provide input into functions strategy.
  • Collaborate with industry peers and trade associations to influence the Medicaid capitation rate.
  • Lead sizable staff and have experience in leading other human capital leaders.
Requirements:
  • 8 or more years of technical experience.
  • 5 or more years of management experience.
  • FSA or ASA plus relevant advanced degree, extensive work experience, and/or other relevant professional designations.
  • Experience in more than three functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending) and more than one product.
Preferred Qualifications:
  • Master's degree.
  • Experience analyzing Medicaid capitation rate to identify rate adequacy issues.
  • Experience negotiating Medicaid capitation rate with State Medicaid agencies.
  • Strong Communication Skills.
Benefits:

Humana offers competitive benefits that support whole-person well-being. Our benefits include medical, dental and vision benefits, 401(k) retirement savings plan, time off, company and personal holidays, volunteer time off, paid parental and caregiver leave, short-term and long-term disability, life insurance and many other opportunities.

About Humana:

Humana Inc (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion.

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