Actuary - Primary Care Organization

Become a part of our caring community   The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Actuary, Analytics/Forecasting works on problems of diverse scope and complexity ranging from moderate to substantial. The Actuary, Primary Care Organization (PCO) is responsible for supporting actuarial analytics, forecasting, data integrity, and business intelligence initiatives. This role develops and executes processes and controls to ensure the accuracy, consistency, and reliability of data used in actuarial analysis and decision-making. The Actuary collaborates with business partners and stakeholders to understand business needs, identify issues, troubleshoot data anomalies, conduct root cause analyses, and develop cost-effective solutions. This position advises leaders and executives on matters of significance, including segment-specific strategies, financial trends, medical claims drivers, and the organization’s short-, medium-, and long-term financial and competitive position. This role works under minimal supervision, exercises independent judgment, and makes decisions on complex actuarial matters requiring analysis of variable factors and determination of the appropriate course of action. *Sponsorship is not available for this role Use your skills to make an impact   Core Responsibilities Collaborate with stakeholders to understand business needs, clarify issues, and translate actuarial findings into actionable business insights. Analyze medical claims trends and identify key drivers impacting financial performance, utilization, cost, and business outcomes. Develop, maintain, and execute processes and controls to ensure data integrity, accuracy, and consistency across actuarial analyses and reporting. Troubleshoot data anomalies, perform root cause analysis, and recommend cost-effective resolutions to improve data quality and business intelligence. Analyze and forecast financial, economic, and business data to support strategic and operational decision-making. Apply actuarial modeling, technical expertise, and industry knowledge to evaluate the organization’s financial and competitive position over the short, medium, and long term. Provide strategic guidance to executives and business leaders on matters of significance, including segment-specific actuarial and financial strategies. Prepare, present, and document actuarial analyses, assumptions, findings, and recommendations for leadership and key stakeholders. Exercise independent judgment on complex actuarial issues, evaluating variable factors and determining appropriate courses of action with minimal supervision. Establish metrics, monitor trends, and deliver data-driven insights that support business planning, forecasting, reporting, pricing, reserving, rate filing, and trend analysis initiatives. Required Qualifications Bachelor’s degree from an accredited University in the USA Member of the American Academy of Actuaries, also known as  MAAA Fellow of the Society of Actuaries, also known as  FSA ; or Associate of the Society of Actuaries, also known as  ASA , plus one or more of the following: Experience working as an Actuary in one or more of the following insurance areas: o    Medicaid o    Medicare Advantage o    Commercial insurance Experience in more than three actuarial functions, such as: o    Modeling o    Pricing o    Rate filing o    Reporting and analysis o    Reserving o    Trending Demonstrated ability to conduct actuarial analysis, interpret complex data, and provide recommendations that support business decision-making. Strong ability to present findings, recommendations, and actuarial analyses to stakeholders and leadership. Preferred Qualifications: Master’s degree Actuarial experience in healthcare Experience using SAS, SQL, Snowflake, or other relevant data analytics, database, or reporting tools Experience supporting medical claims trend analysis, forecasting, business intelligence, or financial analysis in a healthcare or managed care environment Experience documenting actuarial analyses and communications in alignment with applicable actuarial standards, including ASOP 41, Actuarial Communications Work Style: Remote anywhere in USA. Occasional travel to Humana's offices for training or meetings may be required. Work Hours : Typical business hours are Monday-Friday, 8 hours/day, 5 days/week. Very minimal travel might be required for training, meetings, and/or conferences Work at Home Requirements : WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided with payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.  Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Interview Format:  As part of our hiring process, we will be using on-demand technology provided by Hire Vue, a third-party vendor. This technology provides our team of recruiters and hiring managers with an enhanced method for decision-making through on-demand candidate assessments. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in an on-demand assessment with pre-determined questions. You should anticipate the assessment to take approximately 10-15 minutes. Your on-demand assessment wil