This is can be a remote position anywhere in the U.S.A.
Join a high-performing actuarial team supporting CVS Health and Aetna's Government Services Medicare Advantage business. This position will be responsible for leading the pricing and analytic work in support of a department mission to protect Aetna's financial integrity, collaborate with business partners to provide sound risk management advice, anticipate and recognize matters that materially affect financial results, and make sound, unbiased recommendations on these matters.
Leadership - Management of Resources
• Successfully manage projects and initiatives to conclusion, Exhibit innovative use of resources.
• Exercise decision making within scope of authority.
• May have responsibility for performance management, compensation related decisions and staffing.
• Ensure access to appropriate tools, resources and training.
Product & Business Knowledge
• Demonstrate understanding of existing data sources. Proactively seek out new data sources to support/challenge existing assumptions and recommend alternatives/improvements as necessary.
• Demonstrate understanding of interdepartmental products, programs, processes and policies; research problems and issues and suggest resolution.
• Demonstrate understanding of regulatory compliance issues.
Risk Analysis & Management
• Demonstrate in-depth understanding of specific risks. Share results of analysis with management.
• Compile and analyze filing data. Prepare and submit necessary exhibits for regulatory filings.
• Analyze claim data and make recommendations for appropriate reserve levels.
• Oversee technical support and analysis for planning, forecasting and reporting process. Make recommendations to management.
• Oversee development of pricing and trend for product and/or services. Understand and communicate financial impact to management.
• Develop creative technical solutions to a variety of problems. Stay apprised of technical innovations as potential solutions for actuarial issues and concerns.
• Oversee/manage the development and implementation of tools and models.
• Prioritize changes and enhancements to processes, tools and systems. Coordinate staffing support for resource allocation.
• Oversee development and finalization of business requirements and/or specifications for processes, tools, and systems.
• Manage testing for changes to processes, tools, and systems.
Communication, Collaboration & Consultation
• Represent actuarial /serve as project team lead on interdepartmental teams to shape process and policy. -
• Address complex inquiries. Prepare communications for internal and external constituents. Maintain accurate documentation and manage training and user support for tools and processes. Interaction with Constituents- Independently collaborate with internal and external constituents.
The typical pay range for this role is:
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Bachelor's degree along with 5+ years related work experience
FSA (Fellow of the Society of Actuaries) or ASA (Associate of the Society of Actuaries)
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Prior Medicare Advantage experience is preferred (not required)
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.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.