Lead Actuary - Medicare Part D Strategy & Pricing

CVS Health Corporation; United States; Remote; USD 144,000 - 288,000; Full time

Benefits offered by this job

Health benefits

Retirement savings

Equity awards

Paid time off

Job summary

CVS Health is seeking a Lead Director to join the actuarial team supporting CVS Health and Aetna’s government services group pharmacy business. The role leads pricing, projections, and strategic analyses for large fully-insured clients and unbundled populations, while mentoring a team and collaborating with underwriting, product, sales, and account teams.

You will translate legislative changes into business implications and drive data-driven recommendations, contributing to senior leadership

Qualifications

• 8+ years actuarial/healthcare analytics experience.
• ASA or FSA credential.
• Strong communication and relationship-management skills.
• Proven cross-functional collaboration and leadership.
• Ability to translate actuarial concepts for diverse audiences.
• Ability to manage multiple priorities and deadlines.
• Experience with Medicare Part D/Medicare Advantage preferred.

Responsibilities

• Lead and develop a team responsible for pricing, projections, reporting, and actuarial support for large fully-insured clients and the broader portfolio.
• Provide strategic support for the growing unbundled population, where medical coverage is offered under Medicare Advantage and pharmacy coverage is provided through a separate standalone PDP.
• Partner with Underwriting, Product, Sales, Account teams, and other cross-functional stakeholders on large and complex new business, cross-sell opportunities, and renewal cases.
• Partner with senior management to provide strategic actuarial insight during rate reviews and financial reviews for large and complex cases.
• Translate legislative and regulatory changes into clear business implications for internal stakeholders, consultants, and employer groups.
• Complete and oversee studies used for assumption setting, pricing model development, and other actuarial analyses that support business performance.
• Anticipate and identify issues that could materially affect financial results and develop sound, data-driven recommendations to address them.
• Apply strong technical skills, judgment, and critical thinking to solve complex business problems and deliver actionable solutions.
• Drive the team to take ownership of projects, manage competing priorities and deadlines, and collaborate effectively across functions.
• Develop, coach, and mentor team members to strengthen capability, engagement, and performance.

Skills

Leadership

Communication

Cross-functional collaboration

Strategic thinking

Mentoring/People leadership

Project management

Education

Bachelor's degree

ASA or FSA credential

Job description

CVS Health is seeking a Lead Director to join the actuarial team supporting CVS Health and Aetna’s government services group pharmacy business. The role leads pricing, projections, and strategic analyses for large fully-insured clients and unbundled populations, while mentoring a team and collaborating with underwriting, product, sales, and account teams.

You will translate legislative changes into business implications and drive data-driven recommendations, contributing to senior leadership