Humana Associate Actuary, Product Pricing and Compliance in PNC, United States

Description

The Associate Actuary, Product Pricing and Compliance is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new plans and benefit changes. Provides guidance to Product Development on new product/benefit cost impacts. Develops and maintains pricing tools that price standard and custom benefits. The Associate Actuary, Pricing work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

The Associate Actuary, Product Pricing and Compliance establishes market level financial metrics to align with segment profitability goals, analyzes market level results and projections and develops recommended pricing actions to address gaps to targeted metrics. Leverages market level projections and experience data tools to research root cause and capture insights. Researches and understands competitors in marketplace and collaborates with sales and other partners supporting the markets to develop strategies for profitable membership growth. Accountable for actuarial certifications on rate filings, including attesting to compliance with state and federal rating and benefit regulations. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

  • Perform Mental Health Parity testing for fully insured plans

  • Price impact of product changes driven by regulatory requirements

  • Represent actuarial on segment workgroups for Mental Health Parity and Regulatory Requirements impacting plan design & coverage requirements

  • Serve as the point of contact for regulatory requests related to product compliance

  • Prepares comprehensive documented observations, analyses and interpretations of results including technical reports, summaries and quantitative analyses

  • Requires communication and presentation skills, working independently with non-actuarial business partners including Product Development and Regulatory Compliance

Required Qualifications

  • Bachelor's Degree

  • Associate of Society of Actuaries (ASA) designation

  • Meets eligibility requirements for Humana's Actuarial Professional Development Program (APDP)

  • MAAA

  • Strong communication

Preferred Qualifications

Additional Information

Scheduled Weekly Hours

40

About Us

Equal Opportunity Employer

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