Actuary, Risk and Compliance

Humana

. Manage and oversee actuaries and/or support staff involved in identifying and managing risks .

Posted 9/15/2026full-timeRemote • United StatesSeniorLead💰 $129,300 - $177,800 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in risk management and compliance within Medicare Advantage and Prescription Drug Plan bids, with a strong focus on actuarial practices and regulatory requirements. Capable of leading projects and teams while effectively communicating complex ideas to stakeholders.

Highest-signal resume keywords

Risk ManagementMedicare Advantage ExperienceActuarial ScienceProject LeadershipCompliance with CMS Requirements

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Risk AnalysisFinancial Consequence EstimationOut-of-Pocket Cost Model ManagementBid-Filing Process ImprovementActuarial TechniquesRegulatory ResearchCost Control DevelopmentMitigation Strategy AssessmentData InterpretationProject Management

Soft Skills

Effective CommunicationLeadershipCollaborationPeer ReviewCounseling

Certifications & Qualifications

Bachelor's DegreeAssociate in the Society of Actuaries (ASA)Fellow in the Society of Actuaries (FSA)Member of the American Academy of Actuaries (MAAA)

Industry Keywords

CMS ComplianceMedicare BidsTotal Beneficiary CostPHI/HIPAA ComplianceActuarial PracticesInsurance OperationsCost-Effective ApproachesAudit ParticipationBusiness Risk CommunicationProject Involvement

About the role

Key responsibilities & impact

Manage and oversee actuaries and/or support staff involved in identifying and managing risks
Identify and analyze potential risks and estimate potential financial consequences
Develop and recommend controls and cost-effective approaches to minimize risks
Assess risks, opportunities, and mitigation strategies for compliant Medicare Advantage and Prescription Drug Plan bids
Ensure compliance with CMS requirements related to Total Beneficiary Cost
Maintain Humana's internal version of the CMS Out-of-Pocket Cost Model
Obtain required inputs from business partners
Run and interpret the Out-of-Pocket Cost Model results
Partner with pricing actuaries to resolve test failures
Support MA-PD and PDP bid filings through interpretation and implementation of CMS guidance
Implement and execute review standards and controls to minimize bid-filing compliance risk
Participate in CMS audits and reviews related to Medicare bids
Create and maintain bid-filing process improvements
Assess and communicate actuarial and business risks across the organization
Provide peer review and counsel on company, industry, and regulatory practices
Monitor developments in actuarial techniques
Research laws and regulations applicable to actuarial science and insurance operations
Advise executives on significant functional strategies
Potentially lead one direct report

Requirements

What you’ll need

Bachelor's degree
8 or more years of technical experience
2 or more years of project leadership experience
Associate or Fellow in the Society of Actuaries (ASA or FSA)
Member of the American Academy of Actuaries (MAAA)
Ability to articulate ideas effectively in written and oral forms
Medicare Advantage experience preferred
Ability to manage large projects involving actuarial and non-actuarial staff preferred
Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information
Self-provided internet service with at least 25 Mbps download and 10 Mbps upload speed

Benefits

Comp & perks

Bonus incentive plan based upon company and/or individual performance
Medical benefits
Dental benefits
Vision benefits
401(k) retirement savings plan
Paid time off
Company holidays
Personal holidays
Paid parental leave
Paid caregiver leave
Short-term disability
Long-term disability
Life insurance
Wellness and smart healthcare decision support
Occasional travel to Humana offices for training or meetings