Lead Director; Actuarial - Medicaid (SE Region)

CVS Health • Hartford, CT, United States • $200k - $250k / year • 1m ago

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.

Join a high-performing actuarial team supporting CVS Health and Aetna's exciting and growing Medicaid business. Support CVS Health's financial integrity with sound reserving and risk management practices as well as product designs that meet customer needs and pricing that produces returns to shareholders commensurate with the risks undertaken. Actuarial is responsible for anticipating and recognizing matters that materially affect financial integrity and making sound, unbiased reports on these issues.

A Brief Overview

The primary responsibility of this director role will be leading Actuarial market support for the Southeast region’s Medicaid contracts (KY, LA, OHRISE, WV, & VA). Within this role, you’ll:

Lead/manage Plan and analytical support to achieve operating plan goals.
Influence business decisions, anticipate and recognize matters that materially affect financial results and make sound, unbiased reports on these matters.
Lead Actuarial interactions with Market leads – CEO, CFO, CMO and COO.
Interact and drive relationships with external partners, including the MCO Actuarial Coalition and the State’s Actuarial Consulting firm.

Fundamental Components

Provides oversight and guidance related to rate negotiations & renewals with respective internal and external constituents. [Travel may be required]. (30% time)
Develop recommendations and set forecast in collaboration with finance and business partners. (30% time)
Use strong critical thinking skills to creatively solve complex business problems and lead team members to do the same. (10% time)
Assure compliance with Medicaid contract and supplemental analysis requests from market leads or the State. (5% time)
Influence/motivate resources within and outside of direct control to complete projects. (5% time)
Review assumptions developed by staff from a business perspective and be able to influence senior management to accept alternative recommendations. (5% time)
Manage high visibility and complex projects. Allocate and align resources. (5% time)
Coach, mentor and provide feedback to employees in development of technical skills or subject matter expertise. (5% time)
Review reserve recommendations and communicate to health plan leaders. (5% time)

Required Qualifications

Bachelor’s Degree along with 10+ years relevant actuarial work experience
Membership in American Academy of Actuaries is required (ASA or FSA).
Strong Communication & Collaboration Skills
Strong Technical Skills Required (SAS, SQL, Excel)
Proven track record of driving for results with multi-functional teams

Preferred Qualifications:

Prior Commercial, Medicare or Medicaid experience.

Pay Range

The typical pay range for this role is:

$100,000.00 - $231,540.00

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 jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 10/18/2024

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

#J-18808-Ljbffr