Large Group Pricing Actuary

The Large Group Pricing Actuary supports CVS Health's financial integrity through sound risk management practices, customer-focused product design, and pricing strategies that generate shareholder returns commensurate with the risks undertaken. The Actuarial function is responsible for anticipating and identifying issues that may materially impact financial integrity and providing objective, unbiased analysis and reporting on those matters.

The Senior Actuary performs complex actuarial analyses by applying advanced quantitative techniques and analytical methodologies. This role leverages exceptional technical expertise to design and execute data studies, develop innovative solutions, and demonstrate a deep understanding of actuarial principles and business operations. The Senior Actuary also possesses the ability to issue Actuarial Communications in accordance with the Actuarial Standards of Practice.

Gross to Net Trend Forecasting and Pricing Methodology

• Support and evolve the Gross to Net Trend function as a foundational component of forecasting and pricing.
• Analyze and quantify drivers of gross and net trend, assessing their financial impact and relative significance.
• Refine Gross to Net methodologies, assumptions, and modeling approaches to improve accuracy, consistency, and credibility.
• Partner in the monthly Gross to Net process to deliver timely insights and inform pricing recommendations.

Pricing and Cross-Functional Partnership

• Collaborate with Finance, Underwriting, Product, Network, Contracting, Sales, and market leadership to support pricing strategies and key business decisions.
• Provide actuarial expertise on financial performance, forecasting, budgeting, rate actions, filings, and other strategic initiatives.
• Communicate complex actuarial analyses and pricing implications to both technical and non-technical stakeholders.
• Deliver high-quality actuarial support that is timely, responsive, and aligned with business objectives.

Trend Strategy and Leadership

• Develop and enhance trend analytics, documentation, and governance to support pricing assumptions and actuarial decision-making.
• Lead ongoing improvements to trend methodologies, tools, and team knowledge.
• Provide senior leadership with actionable insights on trend drivers, pricing recommendations, risks, and tradeoffs.
• Monitor industry, competitive, regulatory, and macroeconomic developments to inform trend assumptions and pricing strategies.

• Prepares and delivers complex, high-profile actuarial work, providing creative solutions to non-standard business challenges and taking ownership of the overall work product.
• Collaborates effectively across functions on complex initiatives and influences key business decisions through clear, data-driven recommendations.
• Independently reviews work for accuracy, identifies business risks, and develops actionable recommendations. Demonstrates the ability to issue an Actuarial Communication as defined by the Actuarial Standards of Practice.
• Develops actuarial strategies by leveraging industry trends, economic factors, competitive intelligence, and business objectives. Uses multiple data sources and creative problem-solving to drive business outcomes.
• Builds consensus and resolves conflicts through effective written and verbal communication.
• Leads or supports departmental projects and process improvements, including automation and operational enhancements.
• Identifies development opportunities and recommends, creates, and delivers appropriate training solutions.
• Coaches, mentors, and provides feedback to less experienced actuarial professionals to support technical growth and subject matter expertise.
• This role has the potential to manage up to two actuarial professionals.