Associate Actuary, Pricing

The Associate Actuary, Pricing develops and maintains projections of drug utilization trends for Humana's Medicare Part D products to support pricing, forecasting, bid development, and strategic decision-making.

Analyzes historical claims experience, emerging utilization patterns, member behavior, and market dynamics to identify key drivers of pharmacy cost trends and forecast future utilization at the drug, therapeutic class, and product levels.

Leverages actuarial models, experience studies, and analytical tools to research root causes of utilization changes and capture actionable insights.

Collaborates with pricing, forecasting, clinical, pharmacy, formulary, and finance teams to ensure utilization assumptions appropriately reflect emerging experience, operational initiatives, and industry developments.

Monitors external factors, including new drug launches, loss of exclusivity events, clinical guideline changes, and regulatory impacts, to assess their influence on future utilization patterns.

Communicates findings and recommendations to business partners and leadership, supporting sound forecasting and strategic planning decisions.

Begins to influence department strategy through subject matter expertise in Medicare Part D utilization trends.