Talent.com
Actuary, Risk and Compliance
Actuary, Risk and ComplianceHumana Inc • Boston, MA, United States
Actuary, Risk and Compliance

Actuary, Risk and Compliance

Humana Inc • Boston, MA, United States
[job_card.variable_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

Become a part of our caring community and help us put health first

The Lead Actuary, Risk and Compliance is responsible for the overall management and oversight of actuaries and / or support staff where activities are concerned with identifying and managing risks. Identifies and analyzes potential risks and estimates the potential financial consequences, develops and recommends controls and cost‑effective approaches to minimize risks. The Lead Actuary, Risk and Compliance works on problems of diverse scope and complexity ranging from moderate to substantial.

The Lead Actuary, Risk and Compliance assesses and communicates information regarding actuarial / business risks across the organization. Provides peer review and counsel on a wide variety of company, industry, and regulatory practices. Activities may include monitoring developments in actuarial techniques, and researching laws and regulations applicable to actuarial science and insurance 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.

In this specific role, you will be part of a team tasked with assessment of risk, opportunities, and mitigation strategies to assure the compliant submission of bids to support Humana's pricing and product development of Medicare Advantage and Prescription Drug Plans that positively impact the financial performance of Humana.

  • Supporting Humana’s MA‑PD and PDP bid filings by ensuring appropriate interpretation and implementation of CMS guidance, and implementation and execution of review standards and controls to minimize compliance risk associated with the bid filing
  • Participate in CMS audits and reviews related to Humana’s Medicare bids.
  • Create and maintain process improvements to bid filings to continually improve Humana's ability to file compliant bids.

This position comes with the opportunity of leading a team of 2 direct reports.

Use your skills to make an impact

Required Qualifications

  • a 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
  • Member of the American Academy of Actuaries
  • Strong communication skills
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  • Preferred Qualifications

  • Medicare Advantage experience
  • Strong Communication Skills
  • Ability to manage large projects involving actuarial and non‑actuarial staff
  • Additional 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.

    $129,300 - $177,800 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, volunteer time off, paid parental and caregiver leave), short‑term and long‑term disability, life insurance and many other opportunities.

    Application Deadline : 12-30-2025

    About us

    Humana Inc. (NYSE : HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

    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.

    Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https : / / www.humana.com / legal / accessibility-resources?source=Humana_Website.

    #J-18808-Ljbffr

    [job_alerts.create_a_job]

    Actuary • Boston, MA, United States

    [internal_linking.related_jobs]
    Sr. Compliance Analyst (Investment)

    Sr. Compliance Analyst (Investment)

    Jobot • Boston, MA, US
    [job_card.full_time]
    This Jobot Job is hosted by : Amanda Cohen.Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume. Salary : $100,000 - $150,000 per year.We’re a financial services...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Director, Clinical Quality Assurance

    Director, Clinical Quality Assurance

    Eisai • Andover, MA, United States
    [job_card.full_time]
    At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission.We're a growing pharm...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Actuary (Hybrid)

    Actuary (Hybrid)

    American Family Insurance • Boston, Massachusetts, United States
    [job_card.full_time]
    You'll lead, coordinate, or performs most complex analysis for the full range of actuarial activities related to either insurance pricing or ratemaking for the Commercial line of business (LOB), lo...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Assistant Actuary, Commercial Strategic Programs (P&C)

    Assistant Actuary, Commercial Strategic Programs (P&C)

    American Family Mutual Insurance Company • Boston, MA, United States
    [job_card.full_time]
    Homesite is an insurance company that's big on technology.Finding faster and smarter methods of improving how people buy insurance is our jam. Our crew is made up of talented and passionate professi...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Senior Manager, Regulatory Affairs (Biosimilars)

    Senior Manager, Regulatory Affairs (Biosimilars)

    Fresenius Kabi USA, LLC • North Andover, MA, United States
    [job_card.full_time]
    The Senior Manager, Regulatory Affairs delivers Regulatory Affairs and compliance guidance and strategic input as a subject matter expert in Biosimilar Development and Life Cycle Management to find...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Associate Director, Regulatory Compliance

    Associate Director, Regulatory Compliance

    Alnylam Pharmaceuticals • Cambridge, MA, United States
    [job_card.full_time]
    The Associate Director, Regulatory Compliance will help develop and drive department-wide global regulatory compliance strategies, with input from key program, Regulatory, Quality and CMC stakehold...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Actuary

    Actuary

    The Liberty Mutual Foundation • Boston, MA, United States
    [job_card.full_time]
    Are you looking to have a significant impact on the financial results of a Fortune 100 company? As a member of the Mobility Analytics team within the Majors and Mobility team in Global Risk Solutio...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Senior Principal, IT Governance, Risk and Compliance (GRC)

    Senior Principal, IT Governance, Risk and Compliance (GRC)

    American Red Cross • Boston, MA, United States
    [job_card.full_time]
    Please use Google Chrome or Mozilla Firefox when accessing Candidate Home.By joining the American Red Cross you will touch millions of lives every year and experience the greatness of the human spi...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Freelance Clinical Study Respondents (Hiring Immediately)

    Freelance Clinical Study Respondents (Hiring Immediately)

    Maxion Research • Stoughton, Massachusetts, US
    [job_card.part_time]
    Join Our Part-Time Research Studies Today!.Are you eager to earn extra income from the comfort of your home? We are looking for motivated individuals to participate in paid research studies includi...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Assistant Professor- Cybersecurity Focus, Department of Criminal Justice

    Assistant Professor- Cybersecurity Focus, Department of Criminal Justice

    InsideHigherEd • Bridgewater, Massachusetts, United States
    [job_card.full_time]
    Assistant Professor- Cybersecurity Focus, Department of Criminal Justice.Bridgewater State University’s Department of Criminal Justice invites applications for a full-time, tenure-track position to...[show_more]
    [last_updated.last_updated_30] • [promoted]
    VP Finance / Controller - South of Boston

    VP Finance / Controller - South of Boston

    CFS • Taunton, MA, US
    [job_card.full_time]
    Why the VP Finance / Controller opportunity : .The Company : $40M multi-location nonprofit that has experienced 60% growth in the past 4 years. Community Impact : Our client assists individuals with devel...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Governance, Risk & Compliance (GRC) Experts

    Governance, Risk & Compliance (GRC) Experts

    eTeam • Boston, MA, United States
    [job_card.full_time]
    We are seeking a highly skilled and detail-oriented Governance, Risk, and Compliance (GRC) Expert to join our team.The ideal candidate will be responsible for developing, implementing, and maintain...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Remote Finance Director - AI Trainer ($50-$60 / hour)

    Remote Finance Director - AI Trainer ($50-$60 / hour)

    Data Annotation • Brockton, Massachusetts
    [filters.remote]
    [job_card.full_time] +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Director - Claim Services

    Director - Claim Services

    Boston Mutual Life Insurance Company • Canton, MA, US
    [job_card.full_time]
    All Boston Mutual employees who interact with our policyholders, our producers and our BML associates embrace the principles of our brand and service philosophy. Both our words and our behaviors mat...[show_more]
    [last_updated.last_updated_30] • [promoted]
    AVP, U.S. Orthopedics Account Management, Central

    AVP, U.S. Orthopedics Account Management, Central

    J&J Family of Companies • Raynham, MA, United States
    [job_card.full_time]
    At Johnson & Johnson,?we believe health is everything.Our strength in healthcare innovation empowers us to build a?world where complex diseases are prevented, treated, and cured,?where treatments a...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Actuary (Hybrid)

    Actuary (Hybrid)

    American Family Insurance Agency Staff • Boston, MA, United States
    [job_card.full_time]
    You’ll lead, coordinate, or perform the most complex analysis for the full range of actuarial activities related to either insurance pricing or ratemaking for the Commercial line of business (LOB),...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Remote Financial Manager - AI Trainer ($150 per hour)

    Remote Financial Manager - AI Trainer ($150 per hour)

    Mercor • Brockton, Massachusetts, US
    [filters.remote]
    [job_card.full_time]
    UK / Canada / Europe / Singapore / Dubai / Australia-based • •Investment Banking or Private Equity Experts • • for a research project with a leading foundational model AI lab. You are a good fit if you : - Have •...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    National Litigation & Claims Management Mid to Senior Level Attorney

    National Litigation & Claims Management Mid to Senior Level Attorney

    Wilson Elser Moskowitz Edelman & Dicker LLP • Boston, MA, United States
    [job_card.full_time]
    Founded in 1978, we rank among the top 100 law firms identified by The American Lawyer and 36 in the National Law Journal's survey of the nation's largest law firms. We're also Mansfield Certified P...[show_more]
    [last_updated.last_updated_30] • [promoted]