Actuarial Director for Medicaid Pricing

11 hours ago


Honolulu, Hawaii, United States Humana Full time
Job Title: Director, Actuarial of Medicaid Pricing

At Humana, we are committed to putting health first for our customers, teammates, and communities. We are 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, and improve performance.
  • Collaborate with industry peers and trade associations to influence the Medicaid capitation rate.
  • Lead sizable staff and have demonstrated leadership capability.
  • Experience in leading other human capital leaders and strong communication skills.
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.
  • MAAA.
  • 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 preferred.
  • Experience analyzing Medicaid capitation rate to identify rate adequacy issues.
  • Experience negotiating Medicaid capitation rate with State Medicaid agencies.
  • Experience collaborating with industry peers and trade associations to influence the Medicaid capitation rate.
  • Demonstrated leadership capability, has led sizable staff before.
Benefits:

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.

About Humana:

Humana Inc. (NYSE: HUM) is committed to putting health first for our teammates, customers, and communities. 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.


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