Actuary, Member Mix and Underwriting Margin Analytics - Humana
Santa Fe, NM
About the Job
Become a part of our caring community and help us put health first
The Actuary, Analytics/Forecasting will evaluate changes in membership growth and mix dynamics to understand the impact on underwriting margin. They will work collaboratively with peers across Medicare Risk Adjustment, Membership Growth Analytics, Medicare Finance, and Insurance Products Actuarial to improve forecasting and analytics processes related to membership growth and member mix financial impacts with a focus on aligned assumptions across revenue and claims. They will establish or improve upon processes to value movement from plan to plan (P2P), changes in sales and terms projections, age-ins vs. switchers, ESRD, Hospice, dual status, etc. They will perform ad hoc analytics on member cohorts of interest based on emerging experience and trend drivers, and present results to leaders across Finance and Actuarial.
Additionally, this role will provide Underwriting Margin and budget variance analytics for the Controller/TAF organization.
The Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
Use your skills to make an impact
Required Qualifications
+ Bachelor's Degree
+ FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations.
+ MAAA
+ Strong communication skills
+ Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)
+ Experience in Medicare Advantage pricing, analytics, or forecasting
Preferred Qualifications
+ Experience with member cohort/segmentation, Medicare Membership Report (MMR), Medicare Risk Adjustment (MRA), or membership growth analytics
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.$126,800 - $174,500 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
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.
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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.
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. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
The Actuary, Analytics/Forecasting will evaluate changes in membership growth and mix dynamics to understand the impact on underwriting margin. They will work collaboratively with peers across Medicare Risk Adjustment, Membership Growth Analytics, Medicare Finance, and Insurance Products Actuarial to improve forecasting and analytics processes related to membership growth and member mix financial impacts with a focus on aligned assumptions across revenue and claims. They will establish or improve upon processes to value movement from plan to plan (P2P), changes in sales and terms projections, age-ins vs. switchers, ESRD, Hospice, dual status, etc. They will perform ad hoc analytics on member cohorts of interest based on emerging experience and trend drivers, and present results to leaders across Finance and Actuarial.
Additionally, this role will provide Underwriting Margin and budget variance analytics for the Controller/TAF organization.
The Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
Use your skills to make an impact
Required Qualifications
+ Bachelor's Degree
+ FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations.
+ MAAA
+ Strong communication skills
+ Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)
+ Experience in Medicare Advantage pricing, analytics, or forecasting
Preferred Qualifications
+ Experience with member cohort/segmentation, Medicare Membership Report (MMR), Medicare Risk Adjustment (MRA), or membership growth analytics
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.$126,800 - $174,500 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
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.
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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.
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. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Source : Humana