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Actuarial Analyst 2, Risk and Compliance

Remote US

Become a part of our caring community and help us put health first
 The Actuarial Analyst 2, Risk and Compliance supports 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 Actuarial Analyst 2, Risk and Compliance work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Actuarial Analyst 2, 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 and researching laws and regulations applicable to Medicare Advantage and actuarial science. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.

This specific role 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.


Use your skills to make an impact
 

Required Qualifications

  • Bachelor's Degree

  • Successful completion of at least 3 actuarial exams

  • Strong communication skills

  • Proficient in Excel

Preferred Qualifications

  • SQL and/or VBA experience

Additional Information

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership


Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.


Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

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.


 

$78,800 - $108,500 per year


 

This 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.

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Job Profile

Regions

North America

Countries

United States

Restrictions

California Dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Illinois Montana Must work from home Remote US South Dakota Specific states eligible for internet reimbursement Work from a dedicated space Work from a dedicated space lacking ongoing interruptions Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Work from Home in the state of California, Illinois, Montana, or South Dakota

Benefits/Perks

401k retirement 401k Retirement Savings Bonus Incentive Bonus incentive plan Caring community Competitive benefits Dental Disability Holidays Internet expense reimbursement Life Life Insurance Medical Paid parental and caregiver leave Paid Time Off Parental and Caregiver Leave Personal holidays Smart healthcare decisions Support whole-person well-being Time off Vision Vision Benefits Volunteer time Volunteer time off Work From Home

Tasks
  • Communication
  • Compliance
  • Develop controls
  • Identify and analyze risks
  • Interpretation
  • Participate in cms audits
  • Peer Review
  • Process Improvements
  • Product development
  • Support bid filings
  • Training
Skills

Actuarial science Assessment Audits BI Business CMS Communication Compensation Compliance Dental Excel Healthcare Healthcare services HIPAA Implementation Insurance IT Leadership Life Insurance Management Medicaid Medicare Medicare Advantage Monitoring Organization Organizational Peer review Policy Prescription Pricing Product Development Recruitment Regulations Risk Risk Management SQL Strategy Training VBA Vision Wellness

Experience

3 years

Education

Actuarial science Associate Bachelor's Bachelor's degree Business Communication Education Healthcare Higher IT Management

Certifications

Actuarial exams

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9