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The Director, Actuarial of Medicaid Pricing provides actuarial support across a broad range of actuarial and business needs for specific product lines. You will require an in-depth understanding of how organization capabilities interrelate across the function or segment.
The Director, Actuarial of Medicaid Pricing will report to the Associate VP, Lead Medicaid Actuary.
Key Responsibilities:
Rate Advocacy
Lead proactive rate advocacy efforts across assigned Medicaid markets
Identify gaps between emerging experience vs. state rate assumptions
Develop clear, evidence-based narratives to support rate adequacy discussions with state actuaries and regulators
Partner with market CFOs and leadership to align on advocacy posture, trade-offs, and priorities
Drive earlier engagement with states prior to draft rate development
Represent the organization in external forums
Financial Insight & Risk Identification
Translate financial results into actionable insights
Support reforecast cycles with clear articulation of financial drivers
Identify opportunities to improve financial outcomes in maturing markets
Market Partnership
Serve as the actuarial thought partner to market leadership, finance, and clinical teams
Collaborate with Finance, Health Care Economics, market operation teams
Team Leadership
Lead and develop a team of actuaries; coach toward strategic thinking and storytelling
Standardize approaches to rate review, communication, and escalation of risks
Use your skills to make an impact
Required Qualifications
Bachelor's degree
7 or more years of actuarial experience
Deep experience with Medicaid rate setting or state actuarial processes
Experience working directly with state agencies or consulting on Medicaid rates
5 or more years of management experience
FSA or ASA
MAAA
Experience in more than three functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)
Preferred Qualifications
Track record of leading cross-functional initiatives and influencing without authority
Demonstrated leadership capability, has led sizable staff before
Experience in leading other human capital leaders
Additional Information
Ability to travel up to 15% within the United States
This is a remote position.
Work At Home / Internet 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 required; 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.
SSN Information:
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
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.
$189,400 - $260,500 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.
Application Deadline: 05-06-2026
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at?Humana.com?and at?CenterWell.com.
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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.
