Lead Director, Actuarial Cred - Medicaid

CVS Health; Center Square (PA); On-site; USD 144,200 - 288,400; Full time

Benefits offered by this job

Bonus program

Equity award program

Job summary

CVS Health, including Aetna, is recruiting for a Lead Director, Actuarial - Medicaid who will drive Network Insights and curate support for this Medicaid line of business across geographies.

You will enable market leaders to push network performance analyses, participate in state RFP discussions, and guide a matrixed team to balance risks and opportunities while advancing diversity and inclusion.

Qualifications

• 8+ years actuarial and/or health insurance experience required.
• ASA or FSA designation required.
• 6+ years of advanced Microsoft Office experience.

Responsibilities

• Lead actuarial initiatives for Medicaid network insights and profitability.
• Influence market leaders and drive network performance analysis.
• Participate in state-specific RFP conversations and cross-functional initiatives.

Skills

Actuarial

Health insurance

Education

Bachelor's degree

ASA or FSA

Tools

Microsoft Office

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health's unrivaled presence in local communities and their pharmacy benefits management capabilities, we're joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.

Aetna is recruiting for a Lead Director, Actuarial - Medicaid who will be responsible for understanding and driving action on Network Insights and curating support for this important line of business. This is an entirely Medicaid focused role surrounding delivering on our overarching Medicaid network strategy; it is inclusive of target network development in new geographies, and development of networks to support unique Medicaid member needs.

You will make an impact by:

• Achieving profitability and membership goals with business partners by contributing to strategies and executing them.
• Enabling Network Market leaders to drive Network Performance analysis at a market level- data cubes, HCIC (health care information center), curation of a network, and overall provider performance.
• Participate in state specific RFP conversations.
• Identifying core issues and leveraging colleagues/network to solve them. Navigates several data points, possibly contradictory, and rationalizes recommended course of action, recognizing risks and opportunities. Works with different areas to understand those data points. Recommends logical actions based on data and business acumen that weighs the pros and the cons of calculated risks.
• Forming own opinions based in logic and business sense and also having the flexibility to adjust as new ideas are presented, ie. shows a great balance of confidence, open-mindedness and modesty.
• Ability for divergent thinking for brainstorming and connecting many ideas and ability for convergent thinking to ensure a recommended course of action and execution. When ideas do not work, have the perseverance to move forward and inspire their team to adjust.
• Building and facilitating a team environment of trust to foster collaboration and teamwork. Develops and empowers sharing ideas across the organization.
• Influencing resources within and outside of direct control to complete projects.
• Supporting CVS Health in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve.

The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to many aspects of the company's business, as well as significant interaction with Medicaid business leaders. The candidate will be expected to have the following key attributes:

• Broad experience with all actuarial functions.
• Preferred to have experience leading and influencing others.
• Network background is highly desired.
• Adept at execution and delivery (planning, delivering, and supporting) skills.
• Experience working in a highly matrixed environment.
• Strong experiences in growth mindset (agility and developing yourself and others) skills.
• Demonstrated a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.

Required Qualifications

• Bachelor's degree along with 8+ years of actuarial and/or health insurance experience.
• ASA or FSA required.
• 6+ years of advanced Microsoft Office experience.

Preferred Qualifications

• Medicaid experience.
• Leadership experience with the ability to influence.
• Network background.
• Ability to work independently.

Education

• Bachelor's degree required.

Pay Range

The typical pay range for this role is:

$144,200.00 - $288,400.00

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

• We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/28/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.