Actuarial Director of Medicaid Pricing
3 hours ago
The Director, Actuarial of Medicaid Pricing is a key leadership role that provides actuarial support across a broad range of actuarial and business needs for specific product lines. This position requires an in-depth understanding of how organization capabilities interrelate across the function or segment.
The Director, Actuarial of Medicaid Pricing may be responsible for any combination of valuation, pricing, analytics, forecasting, risk, compliance, and operations. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance.
Provides input into functions strategy.
Responsibilities- Provides actuarial support across a broad range of actuarial and business needs for specific product lines.
- Requires an in-depth understanding of how organization capabilities interrelate across the function or segment.
- May be responsible for any combination of valuation, pricing, analytics, forecasting, risk, compliance, and operations.
- Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes.
- Implements strategic plans, drives goals and objectives, and improves performance.
- Provides input into functions strategy.
- Bachelor's degree
- 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.
- 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
- Experience in leading other human capital leaders
- Strong Communication Skills
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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
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