Actuary, Risk and Compliance
for section headings. Use - for any list of duties/requirements/benefits, and
for prose.
We must not emit heading followed by filler/placeholder text. So ensure each section has content.
Let's extract content.
About the role: The first paragraph: "Become a part of our caring community 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. You will identify and analyze potential risks and estimates the potential financial consequences, develop and recommend controls and cost-effective approaches to minimize risks. You will work on problems of diverse scope and complexity ranging from moderate to substantial. The Lead Actuary, Risk and Compliance will report to the Director, Actuarial Risk & Compliance. 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. In particular, this position is responsible for ensuring compliance with CMS requirements related to Total Beneficiary Cost. This includes maintaining the internal version of the Out-of-Pocket Cost (OOPC) Model published by CMS, obtaining needed inputs from business partners, running and interpreting the model’s results, and partnering with the pricing actuaries to find solutions to resolving test failures. In addition, as a member of the Compliance team this role is responsible for: 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 filingParticipate 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 direct report. The Lead Actuary, Risk and Compliance assesses and communicates information regarding actuarial/business risks across the organization. You will provide 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. You will advise executives to develop functional strategies (often segment specific) on matters of significance."
That's a lot; we can split into About the role (overview) and Responsibilities (list). But we must not duplicate. Let's decide: About the role: brief overview paragraph. Responsibilities: list of duties.
We need to extract responsibilities as list items.
From text: responsibilities include:
- overall management and oversight of actuaries and/or support staff where activities are concerned with identifying and managing risks.
- identify and analyze potential risks and estimate the potential financial consequences.
- develop and recommend controls and cost-effective approaches to minimize risks.
- work on problems of diverse scope and complexity ranging from moderate to substantial.
- report to the Director, Actuarial Risk & Compliance.
- 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.
- ensuring compliance with CMS requirements related to Total Beneficiary Cost.
- maintaining the internal version of the Out-of-Pocket Cost (OOPC) Model published by CMS.
- obtaining needed inputs from business partners.
- running and interpreting the model’s results.
- partnering with the pricing actuaries to find solutions to resolving test failures.
- Supporting Humana’s MA-PD and PDP bid filings by ensuring appropriate interpretation and implementation of CMS guidance.
- 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.
- opportunity of leading a direct report.
- assesses and communicates information regarding actuarial/business risks across the organization.
- provide peer review and counsel on a wide variety of company, industry, and regulatory practices.
- monitoring developments in actuarial techniques.
- researching laws and regulations applicable to actuarial science and insurance operations.
- advise executives to develop functional strategies (often segment specific) on matters of significance.
That's many; we can list them.
Requirements: Required Qualifications list:
- 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)
- Demonstrated ability to articulate ideas effectively in both written and oral forms
Preferred Qualifications:
- Medicare Advantage experience
- Ability to manage large projects involving actuarial and non-actuarial staff
Skills: Could be derived from required/preferred but we might combine into Skills section? The instruction says use sections as appropriate. We could have Skills section summarizing abilities like actuarial modeling, risk analysis, CMS guidance, etc. But we might avoid duplication. Perhaps we can omit Skills if not distinct. But we need to include sections only when posting has real specific content. The posting includes "Required Qualifications" and "Preferred Qualifications". Those could map to Requirements and Qualifications sections. Skills maybe not explicitly listed; we could skip.
Benefits: Description Of Benefits paragraph: list of benefits: medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
We can make a
- list.
Pay: Pay Range: $129,300 - $177,800 per year. Also mention bonus incentive plan. So include Pay section with that info.
Schedule: Scheduled Weekly Hours 40. Also mention remote position, work from home requirements, travel occasional. That's schedule/working conditions. Could include in Schedule section: 40 hours per week, remote, occasional travel, home office requirements (internet speed, dedicated space). We'll include.
Now we need to output HTML fragment only, no /, no markdown.
We'll produce:
About the role
...
Responsibilities
- ...
...
Requirements
- ...
...
Qualifications
- ...
...
Benefits
- ...
...
Pay
...
Schedule
...
Make sure not to include filler like "commensurate with experience". Not present.
We must not repeat job title as heading; we didn't.
We must not include Job ID/requisition numbers; none.
We must remove boilerplate: EEO, Equal Opportunity Employer, Application Deadline, About Us, etc. We'll omit those.
Now craft content.
About the role paragraph: summarize first part maybe up to "Become a part of our caring community". Actually that phrase is fluff but we can keep as part of overview. Let's write a concise paragraph: "The Lead Actuary, Risk and Compliance is responsible for the overall management and oversight of actuaries and/or support staff involved in identifying and managing risks. The role includes identifying and analyzing potential risks, estimating financial consequences, developing controls and cost‑effective approaches to minimize risk, and working on problems of moderate to substantial complexity. The position reports to the Director, Actuarial Risk & Compliance and supports Humana’s Medicare Advantage and Prescription Drug Plan bid filing process, ensuring compliance with CMS requirements, maintaining the internal Out‑of‑Pocket Cost (OOPC) model, and partnering with pricing actuaries to resolve test failures."
That captures.
Responsibilities list: we can combine many items; ensure no duplication.
Let's craft list items:
- Manage and oversee actuaries and support staff focused on risk identification and mitigation.
- Identify and analyze potential risks and estimate their financial impact.
- Develop and recommend controls and cost‑effective approaches to minimize risk.
- Address problems of diverse scope and complexity, from moderate to substantial.
- Report to the Director, Actuarial Risk & Compliance.
- Participate in a team assessing risk, opportunities, and mitigation strategies to ensure compliant bid submissions for Humana’s Medicare Advantage and Prescription Drug Plans.
- Ensure compliance with CMS requirements related to Total Beneficiary Cost.
- Maintain the internal version of the CMS Out‑of‑Pocket Cost (OOPC) model.
- Gather required inputs from business partners.
- Run and interpret the OOPC model results.
- Collaborate with pricing actuaries to resolve model test failures.
- Support MA‑PD and PDP bid filings by interpreting and implementing CMS guidance.
- Implement and execute review standards and controls to reduce compliance risk in bid filings.
- Take part in CMS audits and reviews of Humana’s Medicare bids.
- Create and maintain process improvements to enhance bid filing compliance.
- Lead a direct report and provide peer review and counsel on actuarial, business, and regulatory matters.
- Monitor developments in actuarial techniques and research relevant laws and regulations.
- Advise executives on functional strategies for significant, segment‑specific issues.
That's good.
Requirements list (Required Qualifications):
- 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)
- Demonstrated ability to articulate ideas effectively in both written and oral forms
Qualifications list (Preferred Qualifications):
- Medicare Advantage experience
- Ability to manage large projects involving actuarial and non‑actuarial staff
Benefits list:
- Medical, dental, and vision benefits
- 401(k) retirement savings plan
- Paid time off, company and personal holidays, paid parental and caregiver leave
- Short‑term and long‑term disability coverage
- Life insurance
- Additional wellness and support programs
Pay paragraph:
- The estimated starting base pay range is $129,300 – $177,800 per year for full‑time (40 hours/week) employment, with eligibility for a bonus incentive plan based on company and/or individual performance.
Schedule paragraph:
- This is a remote position with a standard schedule of 40 hours per week. Occasional travel to Humana offices for training or meetings may be required. Home‑office employees must provide a dedicated, interruption‑free workspace and meet minimum internet specifications of 25 Mbps download and 10 Mbps upload (wireless, cable, or DSL); Humana may require upgrades if needed to protect PHI/HIPAA data.
Now produce HTML.
Check for any repeated content: Ensure we didn't include "Become a part of our caring community" phrase; we omitted. That
for prose. We must not emit heading followed by filler/placeholder text. So ensure each section has content. Let's extract content. About the role: The first paragraph: "Become a part of our caring community 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. You will identify and analyze potential risks and estimates the potential financial consequences, develop and recommend controls and cost-effective approaches to minimize risks. You will work on problems of diverse scope and complexity ranging from moderate to substantial. The Lead Actuary, Risk and Compliance will report to the Director, Actuarial Risk & Compliance. 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. In particular, this position is responsible for ensuring compliance with CMS requirements related to Total Beneficiary Cost. This includes maintaining the internal version of the Out-of-Pocket Cost (OOPC) Model published by CMS, obtaining needed inputs from business partners, running and interpreting the model’s results, and partnering with the pricing actuaries to find solutions to resolving test failures. In addition, as a member of the Compliance team this role is responsible for: 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 filingParticipate 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 direct report. The Lead Actuary, Risk and Compliance assesses and communicates information regarding actuarial/business risks across the organization. You will provide 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. You will advise executives to develop functional strategies (often segment specific) on matters of significance." That's a lot; we can split into About the role (overview) and Responsibilities (list). But we must not duplicate. Let's decide: About the role: brief overview paragraph. Responsibilities: list of duties. We need to extract responsibilities as list items. From text: responsibilities include: - overall management and oversight of actuaries and/or support staff where activities are concerned with identifying and managing risks. - identify and analyze potential risks and estimate the potential financial consequences. - develop and recommend controls and cost-effective approaches to minimize risks. - work on problems of diverse scope and complexity ranging from moderate to substantial. - report to the Director, Actuarial Risk & Compliance. - 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. - ensuring compliance with CMS requirements related to Total Beneficiary Cost. - maintaining the internal version of the Out-of-Pocket Cost (OOPC) Model published by CMS. - obtaining needed inputs from business partners. - running and interpreting the model’s results. - partnering with the pricing actuaries to find solutions to resolving test failures. - Supporting Humana’s MA-PD and PDP bid filings by ensuring appropriate interpretation and implementation of CMS guidance. - 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. - opportunity of leading a direct report. - assesses and communicates information regarding actuarial/business risks across the organization. - provide peer review and counsel on a wide variety of company, industry, and regulatory practices. - monitoring developments in actuarial techniques. - researching laws and regulations applicable to actuarial science and insurance operations. - advise executives to develop functional strategies (often segment specific) on matters of significance. That's many; we can list them. Requirements: Required Qualifications list: - 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) - Demonstrated ability to articulate ideas effectively in both written and oral forms Preferred Qualifications: - Medicare Advantage experience - Ability to manage large projects involving actuarial and non-actuarial staff Skills: Could be derived from required/preferred but we might combine into Skills section? The instruction says use sections as appropriate. We could have Skills section summarizing abilities like actuarial modeling, risk analysis, CMS guidance, etc. But we might avoid duplication. Perhaps we can omit Skills if not distinct. But we need to include sections only when posting has real specific content. The posting includes "Required Qualifications" and "Preferred Qualifications". Those could map to Requirements and Qualifications sections. Skills maybe not explicitly listed; we could skip. Benefits: Description Of Benefits paragraph: list of benefits: medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. We can make a
- list.
Pay: Pay Range: $129,300 - $177,800 per year. Also mention bonus incentive plan. So include Pay section with that info.
Schedule: Scheduled Weekly Hours 40. Also mention remote position, work from home requirements, travel occasional. That's schedule/working conditions. Could include in Schedule section: 40 hours per week, remote, occasional travel, home office requirements (internet speed, dedicated space). We'll include.
Now we need to output HTML fragment only, no /, no markdown.
We'll produce:
About the role
...
Responsibilities
- ... ...
Requirements
- ... ...
Qualifications
- ... ...
Benefits
- ... ...
Pay
...
Schedule
...
Make sure not to include filler like "commensurate with experience". Not present. We must not repeat job title as heading; we didn't. We must not include Job ID/requisition numbers; none. We must remove boilerplate: EEO, Equal Opportunity Employer, Application Deadline, About Us, etc. We'll omit those. Now craft content. About the role paragraph: summarize first part maybe up to "Become a part of our caring community". Actually that phrase is fluff but we can keep as part of overview. Let's write a concise paragraph: "The Lead Actuary, Risk and Compliance is responsible for the overall management and oversight of actuaries and/or support staff involved in identifying and managing risks. The role includes identifying and analyzing potential risks, estimating financial consequences, developing controls and cost‑effective approaches to minimize risk, and working on problems of moderate to substantial complexity. The position reports to the Director, Actuarial Risk & Compliance and supports Humana’s Medicare Advantage and Prescription Drug Plan bid filing process, ensuring compliance with CMS requirements, maintaining the internal Out‑of‑Pocket Cost (OOPC) model, and partnering with pricing actuaries to resolve test failures." That captures. Responsibilities list: we can combine many items; ensure no duplication. Let's craft list items: - Manage and oversee actuaries and support staff focused on risk identification and mitigation. - Identify and analyze potential risks and estimate their financial impact. - Develop and recommend controls and cost‑effective approaches to minimize risk. - Address problems of diverse scope and complexity, from moderate to substantial. - Report to the Director, Actuarial Risk & Compliance. - Participate in a team assessing risk, opportunities, and mitigation strategies to ensure compliant bid submissions for Humana’s Medicare Advantage and Prescription Drug Plans. - Ensure compliance with CMS requirements related to Total Beneficiary Cost. - Maintain the internal version of the CMS Out‑of‑Pocket Cost (OOPC) model. - Gather required inputs from business partners. - Run and interpret the OOPC model results. - Collaborate with pricing actuaries to resolve model test failures. - Support MA‑PD and PDP bid filings by interpreting and implementing CMS guidance. - Implement and execute review standards and controls to reduce compliance risk in bid filings. - Take part in CMS audits and reviews of Humana’s Medicare bids. - Create and maintain process improvements to enhance bid filing compliance. - Lead a direct report and provide peer review and counsel on actuarial, business, and regulatory matters. - Monitor developments in actuarial techniques and research relevant laws and regulations. - Advise executives on functional strategies for significant, segment‑specific issues. That's good. Requirements list (Required Qualifications): - 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) - Demonstrated ability to articulate ideas effectively in both written and oral forms Qualifications list (Preferred Qualifications): - Medicare Advantage experience - Ability to manage large projects involving actuarial and non‑actuarial staff Benefits list: - Medical, dental, and vision benefits - 401(k) retirement savings plan - Paid time off, company and personal holidays, paid parental and caregiver leave - Short‑term and long‑term disability coverage - Life insurance - Additional wellness and support programs Pay paragraph: - The estimated starting base pay range is $129,300 – $177,800 per year for full‑time (40 hours/week) employment, with eligibility for a bonus incentive plan based on company and/or individual performance. Schedule paragraph: - This is a remote position with a standard schedule of 40 hours per week. Occasional travel to Humana offices for training or meetings may be required. Home‑office employees must provide a dedicated, interruption‑free workspace and meet minimum internet specifications of 25 Mbps download and 10 Mbps upload (wireless, cable, or DSL); Humana may require upgrades if needed to protect PHI/HIPAA data. Now produce HTML. Check for any repeated content: Ensure we didn't include "Become a part of our caring community" phrase; we omitted. That