Actuary/Statistician, Humana Government Business (Clinical P
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Dover, DE 19904
The Actuary, General provides actuarial support across a broad range of actuarial and business needs for specific product lines. The Actuary, General works on problems of diverse scope and complexity ranging from moderate to substantial.
The Actuary, General may be responsible for any combination of valuation, pricing, analytics, forecasting, risk, compliance, and operations. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
Humana Government Business is seeking an Actuary/Statistician who will focus on using data and statistical modeling to monetize the value and calculate the ROI of our care management programs. To this end, a member of the Discount, Trend & Value-based Care team needs to be an exceptionally strong team player that proactively engagements across HGB while always striving to exceed client expectations. As Humana Military’s product offerings expand rapidly, individuals who can manage a series of projects from initiation to completion are increasingly valuable in supporting business objectives.
As an Actuary/Statistician on Humana Military’s Value Based Care team, you will provide leadership in the measurement and evaluation of risk, as well as recommendations for action, consistent with established actuarial methods and standards.
+ Prepares comprehensive documented observations, analyses and interpretations of results including technical reports, summaries and quantitative analyses regarding the performance of clinical programs to be shared internally and with DHA
+ Performs statistical analyses to determine effectiveness of clinical programs
+ Works with clinical team to identify areas of opportunity to drive financial performance of programs
+ Use statistical modeling and credibility theory to quantify the value of quality performance indicators
+ Credibility and risk adjusted analysis of provider performance related to quality and cost. Ability to create a scorecard for provider performance around effectiveness and efficiency
+ Bachelor’s Degree
+ FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations.
+ 7+ years of experience
+ Strong communication skills
+ Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)
+ Proficient with Microsoft Excel, SAS and Access or other data software
+ Prior experience quantifying the cost savings/value of clinical programs
+ Clearly understand clinical programs designs and outcomes
+ Strong statistical background with prior experience in credibility analysis, randomized studies, and study designs
+ Experience conducting economic analysis and valuation of healthcare programs
+ Our Department of Defense contract requires U.S. Citizenship for this role
+ Emotional intelligence
+ Ability to translate technical issues for non-Actuarial audiences
+ Negotiation skills
+ Ability to manage conflict
+ Demonstrated ability to distinguish true sense of urgency
+ Demonstrated strategic influence throughout organization
+ Familiarity with OPTUM EBM, Episode of Care
+ Advanced Technology Skills (SQL, SAS, Access, Tableau)
+ Location: Louisville, KY, other Humana office or WAH
+ Will be required to receive approval for government security clearance (eQIP – Electronic Questionnaire for Investigation Processing)
Scheduled Weekly Hours
Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms -when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
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