The Actuary, Risk and Compliance is responsible for the overall management and oversight of actuaries and/or support staff where activities are concerned with identifying and managing risks. Identifies and analyzes potential risks and estimates the potential financial consequences, develops and recommends controls and cost-effective approaches to minimize risks. The Actuary, Risk and Compliance works on problems of diverse scope and complexity ranging from moderate to substantial.
The Actuary, Risk and Compliance assesses and communicates information regarding actuarial/business risks across the organization. Provides peer review and counsel on a wide variety of company, industry, and regulatory practices. Activities may include monitoring developments in actuarial techniques, and researching laws and regulations applicable to actuarial science and insurance operations. 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.
In this specific role, you will be part of a team tasked with assessment of risk , opportunities, and mitigation strategies to assure the compliant submission of bids to support Humana's pricing and product development of Medicare Advantage and Prescription Drug Plans that positively impact the financial performance of Humana.
- Supporting Humana’s MA-PD and PDP bid filings by ensuring appropriate interpretation and implementation of CMS guidance, and implementation and execution of review standards and controls to minimize compliance risk associated with the bid filing
- Participate in CMS audits and reviews related to Humana’s Medicare bids.
- Create and maintain process improvements to bid filings to continually improve Humana's ability to file compliant bids.
Typically requires a Bachelor's degree and 8+ years of technical experience, or equivalent and 2+ years of project leadership experience
Associate, or Fellow, in the Society of Actuaries
Member of the American Academy of Actuaries
Medicare Advantage experience
Strong Communication Skills
Ability to manage large projects involving actuarial and non-actuarial staff