Actuary, Risk and Compliance

Humana • Salt Lake City, UT • 18h ago

Become a part of our caring community and help us put health first

The Lead 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.

This Lead Actuary role within the Insurance Products Actuarial Compliance team is focused on development of compliant bid inputs for Related Parties. In this role, you will have a unique opportunity to provide guidance and collaborate with business partners and leadership to inform strategy and ensure compliance on this complex and expanding areas. In addition, this role supports compliance of Medicare bid filings and allows you to see the overall end to end bid process at a leading Medicare Advantage organization. This is a great role for a collaborative individual who is detail oriented and enjoys being part of a team that is at the center of a changing regulatory landscape.

The Lead 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 and researching laws and regulations applicable to Medicare Advantage and actuarial science. Advises certifying actuaries, executives and non-actuarial business partners, including Finance, on critical bid inputs for Related Parties. Exercises independent judgment and decision making to determine the best course of action and recommends controls to mitigate risks.

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 pricing and product development of Medicare Advantage and Prescription Drug Plans that positively impact the financial performance of Humana.

Supporting Humana's MA-PD 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

5 or more years of technical experience

2 or more years of project leadership experience

Strong communication skills

Associate or Fellow of the Society of Actuaries

Member, American Academy of Actuaries ?

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Medicare Advantage experience

Ability to manage large projects involving multiple actuarial and non-actuarial staff

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

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.

$129,300 - $177,800 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.

Application Deadline: 08-08-2025

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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Humana

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