Actuary - Pharmacy Analytics

at Humana in Rogers, Arkansas, United States

Job Description


The Actuary role on the Medical Modeling and Specialty Strategies team within Pharmacy Analytics and Consulting (PAC) is an opportunity to provide analytics in support of Humana Pharmacy Solutions infusion strategy. As this area of our pharmacy business continues to grow, you will be an integral part of analyzing and forecasting cost and utilization data to provide insights for strategic decisions. You’ll lead a small team to work with the business owner through valued collaboration to understand and respond to their needs for tracking of emerging experience for current strategies and providing analytics to determine the ‘art of the possible’ as the business ideates through potential future strategies.


Pharmacy Analytics and Consulting provides analytics to multiple business areas within Humana Pharmacy Solutions as well as Humana, Inc. The Actuary role will:

+ Analyze and forecast cost, utilization and other data to provide accurate and timely information for strategic and operational decisions.

+ Make decisions on moderately complex to substantially complex issues regarding technical approach and analysis of situations that require an in-depth evaluation of variable factors for project components.

+ Exercise latitude and independent judgement in determining objectives and approaches to assignments.

Responsibilities include:

+ Supports pharmacy business partners responsible for business development in the specialty pharmacy and pharmacy medical benefits space, including but not limited to Home Infusion services, with appropriate analytics needed to drive business strategy

+ Provides methodology and develops assumptions for business partners’ requests

+ Influences a team/functional area in determining methods and procedures for new and reoccurring tasks

+ Has ownership of work and milestones

+ Builds and maintains analytics tools to ensure business partners can monitor emerging experience

+ Provides analytic support for cross functional strategies involving both medical and pharmacy benefits

+ Utilizes data to create insightful and actionable business information

+ Develops and maintains rapport with business partners to create the appropriate data/analysis to meet their needs

+ Applies appropriate methodologies to project the financial impact of potential medical and pharmacy strategies which involve complex issues

+ Communicates high level summary results to business partners and leadership

+ Completes individual projects, as well as other projects in a dynamic and flexible team environment, with minimal oversight

+ Ensures data integrity by developing and executing necessary processes and controls for data used in business partner requests

+ Collaborates with team members to apply best practices in coding for medical and pharmacy data requests

+ Prepares and maintains documentation of all processes

+ Leads a team of up to 2 associates

Required Qualifications

+ Bachelor’s degree

+ Associate of Society of Actuaries (ASA) designation

+ Member of the American Academy of Actuaries (MAAA)

+ 3+ years of technical experience in data analysis

+ Comprehensive knowledge of Excel

+ Experience with SAS, SQL, and other data systems

+ Experience with tools such as Tableau and Power BI for creating data visualizations

+ Advanced experience working with big and complex data sets within large organizations

+ Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic decision making

+ Proficiency in understanding Healthcare related data

+ Proficiency in verbal and written communications to senior and executive leadership

+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

+ ASA with at least 3 years experience in the health industry

+ FSA with at least 1 year experience in the health industry

+ Prior leadership experience

+ Advanced experience with SQL, SAS and other data systems

+ Advanced experience with tools such as Tableau and Power BI for creating data visualizations

+ Proficient in data mining, forecasting, simulation, and/or predictive modeling

+ Proficient in creating analytics solutions

+ Experience with health care claims and claims payment systems

Additional Information

Scheduled Weekly Hours


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Job Posting: JC186883021

Posted On: Jul 01, 2021

Updated On: Aug 09, 2021