Healthcare Actuary

The Cigna Group; Scottsdale (AZ); Remote; USD 109,000 - 183,000; Full time

Job summary

Join a forward-thinking company as a Healthcare Actuary, where you'll provide critical actuarial analytics support within the Medicare market. This dynamic role involves developing actuarial analyses, collaborating with cross-functional teams, and creating innovative analytics products to optimize healthcare strategies. You will leverage your expertise in regulatory environments and prescription drug supply chains to drive impactful insights. With a commitment to diversity and inclusion, this organization offers a supportive environment for all qualified applicants. If you're passionate about making a difference in healthcare, this opportunity is for you.

Benefits

Health Coverage

401(k)

Paid Time Off

Flexible Work Setup

Qualifications

• 5+ years actuarial experience or 3+ years consulting experience.
• Strong modeling, forecasting, and analytics skills.

Responsibilities

• Develop actuarial analytics products for Medicare Part D Plans.
• Collaborate on financial impact of programs and develop strategies.

Skills

Actuarial Science

Financial Forecasting

SQL

R

SAS

Python

Communication Skills

Leadership Skills

Education

Bachelor's Degree in Quantitative Field

Tools

Actuarial Modeling Tools

Job description

Join us 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 clients' Medicare Part D business. It collaborates 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, actuarial modeling, pharmacy network optimization, rebate strategies, regulatory impact assessments, and ad hoc analyses.

The role requires a strategic outlook on various prescription drug actuarial subjects within the industry and regulatory environments.

Essential Responsibilities

• Product Support / Development:
• Develop actuarial analytics products for Express Scripts' Part D Plans.
• Analyze financial impacts of regulatory changes and CMS programs.
• Create models for projecting plan liabilities and premium sensitivities.
• Build and manage actuarial models to improve analytics tools.
• Identify market gaps and develop strategies to address them.

• 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 on the feasibility and financial impact of programs.
• Apply expertise in Part D to facilitate analytics, measure performance, and generate insights.
• Support strategy development with trend analysis, profitability projections, formulary and network optimization, rebates, and risk scoring.
• Gather market intelligence and train internal teams on Medicare Part D analytics.

Qualifications

• Bachelor’s degree in a quantitative field (Actuarial Science, Economics, etc.).
• 5+ years actuarial experience or 3+ years consulting experience.
• ASA (or near ASA) preferred; FSA preferred.
• Experience with Part D Prescription Drug or bid development is preferred.
• Regulatory and PBM/healthcare experience is preferred.
• Strong modeling, forecasting, and analytics skills.
• Excellent communication and leadership skills.
• Coding skills in SQL, R, SAS, or Python are preferred.
• Deep understanding of US Prescription drug supply chain and Medicare, especially Part D, is preferred.

Work setup may include remote work with required internet speeds. Salary ranges from $109,400 to $182,300 annually, plus potential bonuses. 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.

We value diversity and encourage all qualified applicants to apply. Reasonable accommodations are available upon request.