Actuary - Primary Care Organization

Become a part of our caring community The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization’s short, medium and long-term financial and competitive position. The Actuary, Analytics/Forecasting works on problems of diverse scope and complexity ranging from moderate to substantial. The Actuary, Primary Care Organization (PCO) is responsible for supporting actuarial analytics, forecasting, data integrity, and business intelligence initiatives. This role develops and executes processes and controls to ensure the accuracy, consistency, and reliability of data used in actuarial analysis and decision-making. The Actuary collaborates with business partners and stakeholders to understand business needs, identify issues, troubleshoot data anomalies, conduct root cause analyses, and develop cost-effective solutions. This position advises leaders and executives on matters of significance, including segment-specific strategies, financial trends, medical claims drivers, and the organization’s short-, medium-, and long-term financial and competitive position. This role works under minimal supervision, exercises independent judgment, and makes decisions on complex actuarial matters requiring analysis of variable factors and determination of the appropriate course of action. *Sponsorship is not available for this role Use your skills to make an impact Core Responsibilities Collaborate with stakeholders to understand business needs, clarify issues, and translate actuarial findings into actionable business insights. Analyze medical claims trends and identify key drivers impacting financial performance, utilization, cost, and business outcomes. Develop, maintain, and execute processes and controls to ensure data integrity, accuracy, and consistency across actuarial analyses and reporting. Troubleshoot data anomalies, perform root cause analysis, and recommend cost-effective resolutions to improve data quality and business intelligence. Analyze and forecast financial, economic, and business data to support strategic and operational decision-making. Apply actuarial modeling, technical expertise, and industry knowledge to evaluate the organization’s financial and competitive position over the short, medium, and long term. Provide strategic guidance to executives and business leaders on matters of significance, including segment-specific actuarial and financial strategies. Prepare, present, and document actuarial analyses, assumptions, findings, and recommendations for leadership and key stakeholders. Exercise independent judgment on complex actuarial issues, evaluating variable factors and determining appropriate courses of action with minimal supervision. Establish metrics, monitor trends, and deliver data-driven insights that support business planning, forecasting, reporting, pricing, reserving, rate filing, and trend analysis initiatives. Required Qualifications Bachelor’s degree from an accredited University in the USA Member of the American Academy of Actuaries, also known as MAAA Fellow of the Society of Actuaries, also known as FSA ; or Associate of the Society of Actuaries, also known as ASA , plus one or more of the following: Experience working as an Actuary in one or more of the following insurance areas: Experience in more than three actuarial functions, such as: oMedicaid oMedicare Advantage oCommercial insurance oModeling oPricing oRate filing oReporting and analysis oReserving oTrending Demonstrated ability to conduct actuarial analysis, interpret complex data, and provide recommendations that support business decision-making. Strong ability to present findings, recommendations, and actuarial analyses to stakeholders and leadership. Preferred Qualifications: Master’s degree Actuarial experience in healthcare Experience using SAS, SQL, Snowflake, or other relevant data analytics, database, or reporting tools Experience supporting medical claims trend analysis, forecasting, business intelligence, or financial analysis in a healthcare or managed care environment Experience documenting actuarial analyses and communications in alignment with applicable actuarial standards, including ASOP 41, Actuarial Communications Work Style: Remote anywhere in USA. Occasional travel to Humana's offices for training or meetings may be required. Work Hours : Typical business hours are Monday-Friday, 8 hours/day, 5 days/week. Very minimal travel might be required for training, meetings, and/or conferences Work at Home Requirements : WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided with payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Interview Format: As part of our hiring process, we will be using on-demand technology provided by Hire Vue, a third-party vendor. This technology provides our team of recruiters and hiring managers with an enhanced method for decision-making through on-demand candidate assessments. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in an on-demand assessment with pre-determined questions. You should anticipate the assessment to take approximately 10-15 minutes. Your on-demand assessment will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. SSN Task via Workday : Should you receive a formal employment offer you will receive a request to enter your SSN into our Workday system to scan for duplicate profiles. 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.$129,300 - $177,800 per yearThis 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: 08-19-2026 About us About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being. About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer atCenterWell.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. #J-18808-Ljbffr Visa Hunt