VP & Actuary responsible for actuarial due diligence and transaction support at Prudential Financial. Collaborating with teams on deal management and actuarial excellence in various markets.
About the role
- Actuary analyzing Medicaid claims, forecasting trends, and building Databricks analytics datasets for Humana. Collaborating with actuarial, financial, and clinical teams.
Responsibilities
- Design and maintain Medicaid claims analytics dataset using Databricks
- Conduct in-depth analysis of healthcare claims utilizing revenue codes, CPT/HCPCS, ICD-10 diagnosis codes, DRG, etc.
- Partner with actuarial, financial, and clinical teams to align on data definitions, methodologies, and reporting
- Identify cost drivers, utilization patterns, and anomalies in Medicaid medical claims data
- Maintain dashboards to communicate key trends to stakeholders
- Ensure data integrity by developing and executing processes and controls around the flow of data
- Collaborate with stakeholders to understand business needs, troubleshoot problems, perform root cause analysis, and develop resolutions for data anomalies
- Advise executives and develop functional strategies on matters of significance
- Analyze and forecast financial, economic, and other data to inform strategic and operational decisions
- Establish metrics and provide data analyses to support business intelligence
Requirements
- Bachelor's Degree
- FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations
- MAAA
- Strong communication skills
- Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)
- Experience in managing large healthcare claim datasets and conducting trend analysis
- Deep understanding of healthcare claims taxonomy (service categories, such as LTSS)
- Advanced knowledge of Databricks, SQL, or Python
- Proficient with data visualization tools such as Power BI and Tableau
- Demonstrated project management skills and ability to gather customer input and translate into business requirements
- Ability to translate complex data into actionable insights
- Ability to travel occasionally to Humana offices for training or meetings
Benefits
- Competitive benefits that support whole-person well-being
- 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
- Bonus incentive plan
- Other opportunities and programs to support associate well-being
Job title
Job type
Experience level
Salary
Degree requirement
Tech skills
Location requirements
Actuarial Pricing Manager responsible for pricing analysis, portfolio monitoring, and collaboration with DA partners at Zurich.
Senior Lead Health Actuary Consultant at Mercer managing client health benefits projects and delivering strategic solutions. Lead health actuarial consulting engagements focused on financial evaluations and plan optimizations in a hybrid role.
Senior Lead Health Actuarial Consultant managing US health benefits strategies at Mercer with a focus on financial projections and client interactions. Engaging in consulting for employers' health plans and insurance renewal negotiations.
ALM Modeling Senior Actuary at Transamerica building and analyzing models for insurance products and portfolios, enhancing company risk adjusted returns through advanced analytics.
Actuarial Analyst Assistant supporting analysis and reporting for Cambia's healthcare actuarial team. Collaborating with peers and contributing to actuarial projects in a hybrid work environment.
Senior Actuarial Analyst working on Personal Lines products and regulatory compliance, utilizing actuarial expertise and data analysis.
Senior Manager in Actuarial and Analytics at Travelers, enhancing loss analytics and reserving capabilities. Collaborating across teams to improve analytical approaches and tools.
Actuarial Analyst II managing actuarial studies and reporting at Elevance Health. Collaborating on experience reports and forecasting with data analysis and modeling tasks.
Actuary Consultant providing expert retirement and benefit program advice to mid to large size companies. Leading pension evaluations and training associates to ensure staff development.