25006465 Actuary - Medicare Part D - Evernorth - Remote

Evernorth Health Services; United States; Remote; USD 109,000 - 183,000; Full time

Job summary

A leading health services company seeks an Actuary specialized in Medicare Part D to support external clients' needs. This remote position involves developing actuarial analyses, collaborating across teams, and managing financial impacts in a regulated environment. Candidates should possess strong analytical skills and a strategic perspective on healthcare finance.

Benefits

Health coverage

401(k)

Paid time off

Qualifications

• Experience in actuarial analytics, specifically in Medicare regulations.
• Strong collaboration and analytical skills are essential.
• Ability to manage complex financial analyses and projects.

Responsibilities

• Co-lead development of actuarial analytics products for Part D Plans.
• Perform financial analyses of regulatory changes and CMS programs.
• Develop analytics roadmaps for revenue and cost strategies.

Skills

Financial analysis

Actuarial modeling

Data analysis

Strategic development

Job description

25006465 Actuary - Medicare Part D - Evernorth - Remote

Join to apply for the 25006465 Actuary - Medicare Part D - Evernorth - Remote role at Evernorth Health Services.

This position provides external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space. It is designed to support Express-Script’s external clients' Medicare Part D business, working across teams including trend, formulary, clinical, knowledge solutions, sales & account management, and supply. Responsibilities include developing actuarial analyses for Medicare Part D, such as CMS programs, drug expense analyses, financial forecasts, actuarial modeling, pharmacy network optimization, rebate strategies, regulatory impact assessments, and ad hoc analyses.

The role requires a strategic perspective on actuarial prescription drug topics within the enterprise, industry, and regulatory environments.

Essential Responsibilities

Product Support / Development

• Co-lead development of actuarial analytics products for existing Part D Plans.
• Perform financial analyses of regulatory changes and CMS demonstration programs to assess financial impact.
• Develop models for projecting plan liabilities and premium sensitivities.
• Build models and project management tools to improve analytics capabilities.
• Lead studies to identify market gaps and develop strategies.

Analytics Support to Part D Plans

• Develop analytics roadmaps for revenue and cost strategies.
• Review bid assumptions and create analytics for bid substantiation and audits.
• Perform complex actuarial analyses for Part D health plans.

Cross-Functional Financial Support

• Collaborate with internal and external partners to assess program feasibility and financial impact.
• Apply expertise to facilitate analytics, measure performance, and generate insights.
• Support strategic development in areas like trend analytics, MLR, formulary, clinical analytics, cost analysis, risk scoring, and regulatory impact.

Note: For remote work, internet must have at least 10Mbps download and 5Mbps upload speeds.

Salary range: $109,400 - $182,300 annually, with potential for bonuses. Benefits include health coverage, 401(k), paid time off, and more.

About Evernorth Health Services

A division of The Cigna Group, creating solutions to improve health and vitality. We innovate to make healthcare more accessible.

Qualified applicants are considered regardless of race, color, age, disability, sex, and other protected characteristics. For accommodations, email [e-mail].

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Finance and Sales
• Industries: Hospitals and Healthcare