Hybrid Actuary, Medicaid Trend Analytics and Data Management

at Humana

• Job title: Actuary, Medicaid Trend Analytics and Data Management
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $129,300 - $177,800 per year
• Degree requirement: Bachelor's Degree
• Tech skills: Python, SQL, Tableau
• Location requirements: Hybrid, United States

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