Lead Director; Actuarial - Medicare Network

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary
Aetna is recruiting for a Lead Director, Actuarial - Medicare who will be responsible for understanding and driving action on Medicare Network Insights and curating support for this important line of business. This is an entirely Medicare focused role surrounding delivering on our overarching Medicare network strategy; it is inclusive of target network development in new geographies, and development of networks to support unique Medicare member needs.You will make an impact by:

• Achieving profitability and membership goals with business partners by contributing to strategies and executing them.
• Enabling Network Market leaders to drive Network Performance analysis at a market level-data cubes, HCIC (health care information center), curation of a network, and overall provider performance.
• Participate in state specific RFP conversations.
• Identifying core issues and leveraging colleagues/network to solve them. Navigates several data points, possibly contradictory, and rationalizes recommended course of action, recognizing risks and opportunities. Works with different areas to understand those data points. Recommends logical actions based on data and business acumen that weighs the pros and cons of calculated risks.
• Forming own opinions based in logic and business sense and also having the flexibility to adjust as new ideas are presented, ie. shows a great balance of confidence, open mindedness and modesty.
• Ability for divergent thinking for brainstorming and connecting many ideas and ability for convergent thinking to ensure a recommended course of action and execution. When ideas do not work, have the perseverance to move forward and inspire their team to adjust.
• Building and facilitating a team environment of trust to foster collaboration and teamwork.
• Develops and empowers sharing ideas across the organization.
• Influencing resources within and outside of direct control to complete projects.
• Supporting CVS Health in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve.

Required Qualifications
The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to many aspects of the company's business, as well as significant interaction with Medicare business leaders. The candidate will be expected to have the following key attributes:

• Bachelor's degree along with 10+ years actuarial and/or health insurance experience.
• ASA or FSA designation.
• Knowledge of Medicare products.
• Broad experience with all actuarial functions. Preferred to have experience leading and influencing others.
• Adept at execution and delivery (planning, delivering, and supporting) skills.
• Experience working in a highly matrixed environment.
• Strong experiences in growth mindset (agility and developing yourself and others) skills.
• Advanced Excel application design skills, with ability to pull/manipulate data using SQL.
• Demonstrated a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.

Pay Range

The typical pay range for this role is:$144,200.00 - $288,400.00

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.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 09/19/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Spring House, PA

Job ID: CVS-R0642581_1003

Employment Type: FULL_TIME

Posted: 2025-07-31T12:39:31