Medicaid Pricing Actuary

Overview Become a part of our caring community and help us put health first The Medicaid Pricing Actuary provides actuarial support across a broad range of actuarial and business needs for Medicaid product lines. You will work on problems of diverse scope and complexity ranging from moderate to substantial. The Medicaid Pricing Actuary will report to the Lead Pricing Actuary (Market Manager). You may be responsible for any combination of capitation rate review, drafting rate advocacy communications, actual-to-expected business analytics, forecasting market-specific financial results, and ad hoc market support. You will advise executives to develop functional strategies (often segment specific) on matters of significance. You will exercise independent judgment and decision making on complex issues regarding job duties and related tasks and works under minimal supervision. You will use independent judgment requiring analysis of variable factors and determining the best course of action. Use your skills to make an impact Responsibilities Capitation rate review Drafting rate advocacy communications Actual-to-expected business analytics Forecasting market-specific financial results Ad hoc market support Advise executives to develop functional strategies (often segment specific) Exercise independent judgment and decision making on complex issues 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 technical skills 7+ years of technical experience Demonstrated ability to articulate ideas effectively in both written and oral forms Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending) Preferred Qualifications Knowledge of Medicaid regulations, programs, and state plan benefits Experience with capitation rate development from either the state agency or payer perspective Detailed understanding of healthcare claims 2+ years of project leadership experience Additional Information This is a remote position. Work At Home / Internet Information: To ensure Home or Hybrid Home/Office employees are able to work effectively, the self-provided internet service must meet criteria (minimum download 25 Mbps and upload 10 Mbps). Satellite, cellular and microwave connections can be used only if approved by leadership. Employees in CA, IL, MT, or SD will receive a bi-weekly payment for internet expenses. Humana will provide home/Hybrid Home/Office employees with telephone equipment to meet business requirements. Work from a dedicated space free of interruptions to protect member PHI / HIPAA information. SSN Alert: Applicants may be asked to provide their Social Security Number as part of the application process on Humana's secure website. Travel: Occasional travel to Humana's offices for training or meetings may be required. Other Details Scheduled Weekly Hours : 40 Pay Range : $129,300 - $177,800 per year This job is eligible for a bonus incentive plan based on company and/or individual performance. Description of Benefits : Humana offers medical, dental and vision benefits, 401(k), paid time off, disability, life insurance, and other opportunities. Application Deadline : 04-02-2026 About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health. Equal Opportunity Employer Humana is an equal opportunity employer. It is the policy of Humana not to discriminate in employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or protected veteran status. We comply with applicable civil rights laws and provide free language interpreter services. See our accessibility resources at Humana's website. #J-18808-Ljbffr