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:

This position is responsible for rate development and filings in the Individual ACA segment. This entails

• Contributing to the achievement of profitability and membership goals by acting as a strategic partner with business partners

• Develop or recommend initiatives to drive down cost structure by working with multiple business partners (segment management, network, product, finance, compliance, etc) so price points can be competitive and achieve required financial goals

• Navigate several data points, possibly contradictory, and rationalize recommended course of action, recognizing risks and opportunities. Work with different areas to understand those data points..

• Devise responsible pricing strategies to achieve business objectives. Recommend decisions logically based on data and business acumen that weighs the pros and cons and considers calculated risks.

• Cultivate relationships with local regulators and negotiate terms of rate filings and approvals; communicate both in response to objections and proactively as needed

This position is also responsible for:

• Maintaining monthly date of service reporting database used by the actuarial team

• Update downstream reporting tools for all Individual ACA business to enhance understanding of financial performance

• Enhancement of reporting and development of ad hoc analyses as appropriate to understand financial drivers

• Management of several team members, including day to day responsibilities and professional development.

Required Qualifications:

- Bachelor’s degree along with 5+ years related experience

- ASA/FSA credential
- Experience with Microsoft Office suite, especially Excel

- Prior healthcare experience
- Ability to work with large and detailed data sets: SQL,  Power BI a plus,
- Strong communication skills
- Strong technical/analytical skills and attention to detail
 

Preferred Qualifications:

Experience with ACA markets

Education :

Bachelor’s degree or equivalent experience

Pay Range

The typical pay range for this role is:

$75,400.00 - $182,549.40

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: 01/10/2025

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