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Actuary, Risk and Compliance
Humana - Mansfield, TX
posted 2 months ago
About the position
The Actuary, Risk and Compliance role at Humana is focused on special Medicare Advantage programs, including Value Based Insurance Design (VBID) and Special Supplemental Benefits for the Chronically Ill (SSBCI). This position involves collaboration with business partners and leadership to ensure compliance with Medicare bid filings and to assess and communicate actuarial and business risks across the organization. The role requires a detail-oriented individual who can navigate a changing regulatory landscape and contribute to the overall bid process at a leading Medicare Advantage organization.
Responsibilities
- Provide guidance and collaborate with business partners and leadership on Medicare Advantage programs.
- Support compliance of Medicare bid filings and oversee the end-to-end bid process.
- Assess and communicate information regarding actuarial/business risks across the organization.
- Monitor and research laws and regulations applicable to Medicare Advantage and actuarial science.
- Advise certifying actuaries, executives, and non-actuarial business partners on VBIDs and SSBCI.
- Participate in CMS audits and reviews related to Humana's Medicare bids.
- Create and maintain process improvements to bid filings to enhance compliance.
Requirements
- Bachelor's degree
- 7 or more years of technical experience
- 2 or more years of project leadership experience
- MAAA: FSA preferred, or ASA with commensurate years of experience
- Demonstrated ability to communicate as a leader and with other areas of the business
- Experience conveying complex analyses and concepts to non-technical audiences
- Proven ability to exercise independent judgment on complex issues
Nice-to-haves
- Medicare Advantage and/or Part D experience
- Demonstrated ability to manage large projects involving actuarial and non-actuarial staff
- Experience in reviewing and interpreting regulatory documents
- Demonstrated ability to assess risks
- Experience developing controls to mitigate risks
Benefits
- Medical, dental and vision benefits
- 401(k) retirement savings plan
- Paid time off including company and personal holidays
- Volunteer time off
- Paid parental and caregiver leave
- Short-term and long-term disability
- Life insurance
