Associate Actuarial Director – Individual Medicare Advantage

This is a fully remote position, open to applicants in United States.

📋 Description

• Establish pricing assumptions, submit bids, and secure approval for premium rates and rate certifications with regulatory authorities.

• Assist in the implementation of rates, new plans, and modifications to benefits.

• Offer guidance to Product Development regarding the cost impacts of new products and benefits.

• Create and maintain pricing tools for both standard and customized benefits.

• Set financial metrics at the market level that align with profitability objectives for different segments.

• Analyze results and projections at the market level to suggest pricing strategies.

• Investigate root causes using market-level projections and analytical data tools.

• Examine competitor strategies and collaborate with market partners to develop successful membership growth strategies.

• Provide actuarial certifications for rate filings and ensure compliance with state and federal regulations regarding ratings and benefits.

• Oversee 2–3 Medicare Advantage regions.

• Review individual Medicare Advantage bids for accuracy and regulatory compliance.

• Support regular forecasting and offer financial guidance to leadership.

• Engage in cross-functional workgroups.

• Supervise 2–3 direct reports and a total team of 4–7 associates.

⛳️ Requirements

• Bachelor’s degree.

• Minimum of 5 years of experience in Medicare Advantage bid filing.

• FSA, ASA, or MAAA designation.

• Experience in at least three functional areas, including modeling, pricing, rate filing, reporting and analysis, reserving, or trending.

• Experience with multiple products.

• Ability to effectively communicate ideas in both written and oral formats.

• A dedicated workspace free from ongoing interruptions to protect member PHI/HIPAA information.

• Home internet connection with a minimum download speed of 25 Mbps and upload speed of 10 Mbps.

• Willingness and ability to travel occasionally to Humana offices for training or meetings.

🏝️ Benefits

• Bonus incentive plan based on individual and/or company performance.

• Medical, dental, and vision coverage.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance.

• Internet expense reimbursement for employees residing and working from home in California, Illinois, Montana, or South Dakota.

• Telephone equipment suited to business needs.

• Remote work flexibility.

• Occasional travel to Humana offices for training or meetings.