Actuarial Director - Medicaid Pricing
$189.4k - $260.5kFull-time
Humana
Role Description
The Director, Actuarial of Medicaid Pricing provides actuarial support across a broad range of actuarial and business needs for specific product lines. You will require an in-depth understanding of how organization capabilities interrelate across the function or segment. The Director will report to the Associate VP, Lead Medicaid Actuary.
- Rate Advocacy
- Lead proactive rate advocacy efforts across assigned Medicaid markets
- Identify gaps between emerging experience vs. state rate assumptions
- Develop clear, evidence-based narratives to support rate adequacy discussions with state actuaries and regulators
- Partner with market CFOs and leadership to align on advocacy posture, trade-offs, and priorities
- Drive earlier engagement with states prior to draft rate development
- Represent the organization in external forums
- Financial Insight & Risk Identification
- Translate financial results into actionable insights
- Support reforecast cycles with clear articulation of financial drivers
- Identify opportunities to improve financial outcomes in maturing markets
- Market Partnership
- Serve as the actuarial thought partner to market leadership, finance, and clinical teams
- Collaborate with Finance, Health Care Economics, market operation teams
- Team Leadership
- Lead and develop a team of actuaries; coach toward strategic thinking and storytelling
- Standardize approaches to rate review, communication, and escalation of risks
Qualifications
- Bachelor's degree
- 7 or more years of actuarial experience
- Deep experience with Medicaid rate setting or state actuarial processes
- Experience working directly with state agencies or consulting on Medicaid rates
- 5 or more years of management experience
- FSA or ASA
- MAAA
- Experience in more than three functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)
Preferred Qualifications
- Track record of leading cross-functional initiatives and influencing without authority
- Demonstrated leadership capability, has led sizable staff before
- Experience in leading other human capital leaders
Requirements
- Ability to travel up to 15% within the United States
- This is a remote position.
Benefits
- 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
- Many other opportunities
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.
$189,400 - $260,500 per year
This job is eligible for a bonus incentive plan based upon company and/or individual performance.
Application Deadline
05-06-2026
Vacancy posted 3 days ago
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