Healthcare Actuary

The Cigna Group; Philadelphia (Philadelphia County); Remote; USD 109,000 - 183,000; Full time

Job summary

An established industry player is seeking a Healthcare Actuary to provide external actuarial analytics support within the Medicare market. This exciting role involves developing analyses for Medicare Part D, collaborating with various teams, and leading studies to enhance analytics capabilities. The ideal candidate will have a strong background in actuarial science, excellent communication skills, and expertise in regulatory compliance. Join a forward-thinking company that values innovation and offers a comprehensive benefits package, including health coverage and a 401(k). If you're passionate about making a difference in healthcare, this opportunity is perfect for you.

Benefits

Health Coverage

401(k)

Paid Time Off

Flexible Work Hours

Qualifications

• 5+ years actuarial experience or 3+ years consulting required.
• ASA or near ASA preferred; FSA preferred.
• Part D experience preferred, including bid development.

Responsibilities

• Co-lead development of actuarial analytics products for Part D Plans.
• Perform financial analyses of regulatory changes and CMS programs.
• Develop actuarial models for Medicare Part D liabilities.

Skills

Actuarial Analysis

Financial Forecasting

Modeling Skills

Communication Skills

Leadership Abilities

SQL

R

SAS

Python

Understanding of US Prescription Drug Supply Chain

Education

Bachelor’s Degree in Actuarial Science

Bachelor’s Degree in Economics

Bachelor’s Degree in Statistics

Bachelor’s Degree in Finance

Tools

SQL

R

SAS

Python

Job description

Join to apply for the Healthcare Actuary role at The Cigna Group

This position provides external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space. The Actuarial Strategy role supports Express-Script’s external Medicare Part D business, collaborating with internal teams across 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 projections, financial forecasts, and regulatory impact assessments.

The role requires strategic expertise in prescription drug actuarial subjects within enterprise, industry, and regulatory contexts.

Essential Responsibilities

1. Product Support / Development

• Co-lead development of actuarial analytics products for existing Part D Plans
• Perform financial analyses of regulatory changes and CMS programs
• Develop actuarial models for projections of Medicare Part D liabilities and premiums
• Create models and tools to identify market gaps and improve analytics capabilities
• Lead studies to identify and address gaps in the Medicare Part D market

Analytics Support to Part D Plans

• Develop analytics roadmaps for revenue optimization and cost reduction
• 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 internally and externally to assess operational feasibility and financial impact of programs
• Apply Part D expertise to develop insights and support enterprise strategies
• Support financial reconciliation and trend analysis within Medicare Part D
• Develop market benchmarks, gather intelligence, and train teams on Medicare Part D analytics

Qualifications

• Bachelor’s degree in Actuarial Science, Economics, Statistics, Finance, or related field
• 5+ years actuarial experience or 3+ years consulting
• ASA (or near ASA) preferred; FSA preferred
• Part D experience preferred, including bid development and regulatory compliance
• Experience in regulated markets, PBM, healthcare, or pharmaceuticals preferred
• Strong modeling, forecasting, and analytics skills
• Excellent communication and leadership abilities
• Coding skills in SQL, R, SAS, or Python preferred
• Deep understanding of US prescription drug supply chain and Medicare, especially Part D

Remote work requires internet with at least 10 Mbps download and 5 Mbps upload speeds.

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

About Evernorth Health Services: A division of The Cigna Group, focused on pharmacy, care, and benefit solutions to improve health outcomes.

We are an equal opportunity employer and support reasonable accommodations during the application process. We also have a tobacco-free policy in certain states.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Industry: Healthcare