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Humana

Associate Actuary, Pricing

Posted 50 Minutes Ago
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Remote
Hiring Remotely in United States
107K-147K Annually
Mid level
Remote
Hiring Remotely in United States
107K-147K Annually
Mid level
Sets pricing assumptions and develops Medicare Part D bid pricing models. Analyzes claims, drug utilization, member behavior, market dynamics, drug launches, regulatory changes, and clinical developments to forecast pharmacy costs. Maintains pricing tools and utilization projections, researches cost trends, collaborates with pricing, clinical, pharmacy, formulary, and finance teams, and communicates recommendations to leadership.
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The Associate Actuary, Pricing is responsible for setting pricing assumptions to support Medicare Part D bids. You will provide guidance to Product Development on new product/benefit cost impacts. You will develop and maintain pricing tools that price standard and custom benefits.

The Associate Actuary, Pricing develops and maintains projections of drug utilization trends for Humana's Medicare Part D products to support pricing, forecasting, bid development, and strategic decision-making.

  • Analyzes 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.
  • Leverages actuarial models, experience studies, and analytical tools to research root causes of utilization changes and capture actionable insights.
  • Collaborates with pricing, forecasting, clinical, pharmacy, formulary, and finance teams to ensure utilization assumptions appropriately reflect emerging experience, operational initiatives, and industry developments.
  • Monitors external factors, including new drug launches, loss of exclusivity events, clinical guideline changes, and regulatory impacts, to assess their influence on future utilization patterns.
  • Communicates findings and recommendations to business partners and leadership, supporting sound forecasting and strategic planning decisions.
  • Begins to influence department strategy through subject matter expertise in Medicare Part D utilization trends.

Use your skills to make an impact
 

Required Qualifications

  • 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

Additional Information

This is a remote position.

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; 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. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


 

$106,900 - $147,000 per year


 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 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 many other opportunities.

Application Deadline: 09-18-2026
About us
 
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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