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Pharmacy Contracting RFP Pricing Actuary

Humana
Remote US, United States, United StatesRemotefull_timeVerifiedPosted 30 May 2025
💰 $177,800/yr($129,300/yr$177,800/yr)

About the role

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

The Actuary, Analytics/Forecasting is responsible for setting pricing assumptions, submitting RFPs, and monitoring performance of our CenterWell Pharmacy payer agnostic business. This role will support senior leaders in developing our pricing methodologies and sales to external payers. Develops and maintains pricing tools that price standard, cost+, and spread options. The Actuary, Analytics/Forecasting works on problems of diverse scope and complexity ranging from moderate to substantial.

The Actuary, Analytics/Forecasting establishes market level financial metrics to align with CenterWell Pharmacy profitability goals, analyzes market level results and projections, and develops recommended pricing actions to address gaps to targeted metrics to expand our external volumes. It researches and understands competitors in the marketplace and advises CWP and CWSP leadership in developing strategies to increase competitiveness and grow profit for the pharmacy. The role 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. This role is expected to have 2-3 direct reports and needs to balance the above priorities across the team to meet objectives and deadlines.


Use your skills to make an impact
 

Required Qualifications

  • Bachelor's Degree
  • FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations.
  • MAAA
  • Strong communication skills
  • Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)
  • SAS/SQL knowledge
  • Consulting and influencing senior leadership

 

Preferred Qualifications

  • People leader experience
  • Power BI or other visualization software
  • Modeling and developing proposals for pharmacy bids
  • Pharmacy pricing experience
  • Experience working with available industry third-party pharmacy utilization data
  • Tracking actuals vs expected and explaining drivers of variance
  • Identification and tracking of KPIs
  • Explaining complex topics to non-technical audiences

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: 06-17-2025


About us
 

About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.

About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of ho

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Company

Humana

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