Overview
This role supports pricing for Medicare Part D bids by developing and maintaining pricing assumptions, tools, and utilization projections. The Associate Actuary, Pricing provides guidance to Product Development on new product and benefit cost impacts.
Responsibilities
- Set and maintain pricing assumptions to support Medicare Part D bid development.
- Develop and maintain pricing tools that price standard and custom benefits.
- Build and maintain projections of drug utilization trends for Medicare Part D products to support pricing, forecasting, bid development, and strategic decision-making.
- Analyze historical claims experience, emerging utilization patterns, member behavior, and market dynamics to identify key drivers of pharmacy cost trends and forecast future utilization at the drug, therapeutic class, and product levels.
- Use actuarial models, experience studies, and analytical tools to identify root causes of utilization changes and capture actionable insights.
- Collaborate with pricing, forecasting, clinical, pharmacy, formulary, and finance teams to ensure utilization assumptions reflect emerging experience, operational initiatives, and industry developments.
- Monitor external factors—including new drug launches, loss of exclusivity events, clinical guideline changes, and regulatory impacts—to assess their influence on future utilization patterns.
- Communicate findings and recommendations to business partners and leadership to support forecasting and strategic planning decisions.
- Begin to influence department strategy through subject matter expertise in Medicare Part D utilization trends.
Requirements
- Bachelor’s Degree
- Associate of Society of Actuaries (ASA) designation
- MAAA
- Excellent communication and interpersonal skills, including the ability to translate complex topics to both technical and non-technical audiences
- Strong analytical skills
Preferred Qualifications
- Three or more years of Pricing, Medicare and/or Part D experience
- SAS/SQL/R/Databricks programming experience
- Experience with Power BI dashboards
- Experience with model building, exploratory analysis, and/or developing dashboards
- Highly motivated and willing to learn
Compensation & Benefits
- Scheduled weekly hours: 40
- Pay range (starting base pay estimate): $106,900 - $147,000 per year
- This job is eligible for a bonus incentive plan. Incentive opportunity is based upon company and/or individual performance.
- Benefits include medical, dental, and vision; 401(k) retirement savings plan; time off (including paid time off, company and personal holidays, paid parental and caregiver leave); short-term and long-term disability; life insurance; and other opportunities.
Location
- Remote position.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
- Home internet requirements (self-provided): minimum download speed of 25 Mbps and upload speed of 10 Mbps; wireless, wired cable or DSL connection is suggested.
- In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary.
- Travel: While remote, occasional travel to Humana’s offices for training or meetings may be required.
Application Deadline