Senior Actuary

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

The National Medical Cost Analytics team in the Medical Economics Unit is seeking an actuarial professional with the primary role of leading the development of Aetna’s HCB medical cost and trend analysis thru MENTOR and Emerging Trends reporting. This role will use business acumen to serve as a liaison to business leads and stakeholders in actuarial, product, network, finance, etc. to provide actionable insight in response to medical cost drivers.  The candidate will work in a fast-paced, dynamic, and rapidly changing environment and gain exposure to many different areas of the company through collaboration and communication of results. The role combines a dense subject matter expertise with proficient communication skills.

• Perform complex medical and financial cost analysis to evaluate real time medical cost drivers and develop strategic options and opportunities to favorably impact medical cost in support of Aetna’s business
• Identify key stakeholders across Finance, Actuarial, and Market Leadership to foster successful collaboration in support of broader enterprise strategy
• Leverage strong communication skills and influence to lead development of new reporting, exhibits, and MENTOR/Emerging Trends meeting content; share work product and findings with business stakeholders as part of the quarterly/monthly meeting cycles
• Demonstrate knowledge of external economic, demographic, regulatory, and other Aetna business drivers as well as the overall competitive environment
• Support implementation and creation of enterprise initiatives to respond to medical cost pressures and mitigate unfavorable drivers of business performance
• Apply technology to improve business processes and compliance (SQL, GCP, SmartView, VBA, R, and full suite of Microsoft Office products) and actively participate in the change management process related to emerging technologies and data, specifically the successful launch and adoption of new ADAM (Aetna Date of Service Analytic Model) Cloud platform and daily claims data
• Determine the financial impact resulting from changes to CVS Health and Aetna’s medical cost management strategy, pricing position and earnings generation; provide support related to medical cost actions and medical cost strategy with decision making on pricing and long term, sustainable earnings growth.
• Interface with senior leadership, describing detailed and intricate data in a way that can be digested by VPs and above. 

Required Qualifications

Knowledge of:

• Key managed care functions including provider contracting, benefit design, medical management as well as knowledge of business functions and impact on financials (underwriting, sales, product development, network management)
• Managed Care Organization competitive environment as well as governing regulation

Skill In:

• Expertise analytical and problem-solving skills
• Strong organizational, management and leadership skills
• Excellent written and verbal communication and presentation skills.
• Leading change, developing new content to inform and influence senior business leads and relevant stakeholders

Requirements:

• Bachelor's degree along with 5+ years of relevant work experience.
• ASA or FSA designation required
• Strong technical skills and communication skills to tell a story from the data.
• Manage conflicting priorities and multiple projects concurrently.
• Demonstrate initiative, innovation, and leadership in achieving results
• Demonstrates critical thinking and expresses ideas clearly, concisely, and logically from a cross functional perspective.

Preferred Qualifications

Knowledge of:

• Commercial and Government segments and product strategy including Commercial, IFP, Medicare, and Medicaid

Education

Bachelor’s Degree in actuarial science, mathematics, statistics, or other related field

Pay Range

The typical pay range for this role is:

$118,450.00 - $260,590.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.  This position also includes an award target in the company’s equity award program. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. 
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 04/30/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.