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CVS Health

Runs pharmacies, health plans and clinics

Actuarial Manager - Employer Group Waiver Plan

Actuarial & Risk ModellingConfirmed live in the last 24 hours
Full-time

About the Job

Requirements

  • Apply actuarial standards of practice and sound actuarial judgment to complex business decisions.
  • Have experience performing experience analyses, assumption setting, and profitability studies.
  • Have a bachelor's degree and at least 3 years of relevant actuarial experience.
  • Have strong communication skills.
  • Have strong analytical skills.
  • Hold an Associate of the Society of Actuaries (ASA) credential or demonstrate progress toward actuarial credentials.

Responsibilities

  • Help develop pricing strategies and money-saving options that align with customer needs.
  • Support analysis related to Medicare Part D reform and educate business partners on potential impacts.
  • Partner with Underwriting, Sales, and Account teams on complex new business and renewal cases.
  • Meet with clients as needed to explain economic implications and pricing considerations.
  • Complete or oversee studies used to set assumptions in pricing models.
  • Deliver timely, accurate, high-quality analyses and recommendations.
  • Work independently while collaborating effectively across teams.
  • Identify issues that could materially affect financial results and develop sound, unbiased recommendations.
  • Apply technical expertise and critical thinking to solve business problems.
  • Mentor less experienced team members and support team development.
  • Develop projections, conduct experience studies and Book of Business analyses, and generate data-driven insights for client and enterprise decision-making.
  • Act as the actuarial point person for at least one large Employer Group Waiver Plan client, including recurring reporting and projections.
  • Partner with Sales, Rebate Operations, Underwriting, Clinical, Formulary, and the broader Medicare Part D team to deliver analyses and strategic recommendations supporting growth, financial sustainability, and client success.
  • Use actuarial methodologies, predictive analytics, and experience monitoring to evaluate business performance and support pricing, forecasting, and strategic initiatives.

Desired Qualifications

  • Coding experience.
  • Knowledge of pharmacy benefits and formularies.

About the Company

CVS Health

Runs pharmacies, health plans and clinics

CVS Health runs pharmacies, health insurance plans and medical clinics for individuals, employers and government programs across the United States. Its businesses include CVS Pharmacy, the Aetna insurer and Caremark, which manages prescription coverage and negotiates drug prices for health plans. Patients fill prescriptions in stores or by mail and receive care through walk-in clinics, primary care centers and home visits. The company earns money from prescription sales, insurance premiums, plan administration fees and clinical services, combining coverage with places to obtain treatment. Its first store opened in 1963, and its headquarters are in Woonsocket, Rhode Island.

Company size
10,001+
Company stage
IPO
Headquarters
Woonsocket, Rhode Island
Founded
1963

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