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Position Summary
Join a high-performing actuarial team supporting CVS Health and Aetna's exciting and growing Medicaid business.
A Brief Overview
The primary focus of this role will be leading and driving analytical support and initiatives for Medicaid pharmacy performance.
Fundamental Components
Primary Role (80% time):
- Direct and oversees the actuarial pharmacy team to be strategic business partners.
- Build actuarial pharmacy center of excellence and provide analytical support for plan actuaries in rate setting/RFP in all states.
- Oversees pharmacy trend model development and improvement, and support plan actuaries in understanding and setting forecast trends.
- Lead and drive pharmacy related analysis and storytelling including pricing, trend (Internal & Industry), pipelines, policy/benefits, rebate, formularies, etc.
- Drive regular conversations and collaborations with cross-functional teams including pharmacy, clinical, PBM, Finance, health plan leadership, Medical Economics, etc.
- Work with cross-functional teams to collectively identify results drivers, and follow through with actionable solutions.
Secondary Functions (20% time):
- Direct and oversee an actuarial team to be strategic business partners.
- Provides oversight and guidance related to rate negotiations & renewals with respective States.
- Use strong critical thinking skills to creatively solve complex business problems and lead team members to do the same.
- Identify and support process improvement through automation and process simplification; assure timely and accurate deliverables.
- Manage high visibility and complex projects. Allocate and align resources.
- Coach, mentor and provide feedback to employees in development of technical skills or subject matter expertise.
Required Qualifications:
- Bachelor’s Degree along with 10+ years relevant experience
- Must be an ASA or FSA
- Strong Communication & Collaboration Skills
- Strong Technical Skills Required (SAS, SQL, Python)
- Proven track record of driving for results with multi-functional teams
Preferred Qualifications:
- Prior Commercial, Medicare or Medicaid experience
Education
Bachelor or equivalent 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.
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.
