Lead Director; Actuarial - Medicare Part D

CVS Health Corporation; Maine; Hybrid; USD 144,000 - 288,000; Full time

Job summary

CVS Health is seeking a Lead Director for its government services actuarial team, focusing on pricing, projections, and strategic leadership for the fully-insured portfolio. You will guide a high-performing team and collaborate with multiple stakeholders to drive data-driven decisions for large, complex cases.

The role emphasizes translating legislative developments into business implications, mentoring staff, and delivering high-quality actuarial insights to senior leadership.

Qualifications

• Bachelor’s degree with 8+ years actuarial/healthcare analytics.
• ASA or FSA credential required.
• Strong communication and relationship-management skills.
• Proven cross-functional collaboration and leadership.
• Ability to translate complex actuarial concepts for senior audiences.

Responsibilities

• Lead and develop actuarial team for pricing, projections, and reporting.
• Support Medicare Advantage and PDP business with strategic insights.
• Collaborate with Underwriting, Product, Sales, and Account teams on large deals.
• Translate regulatory changes into business implications.
• Mentor team members and manage competing priorities.
• Drive data-driven recommendations to address financial risks.

Skills

Actuarial analysis

Leadership

Cross-functional collaboration

Communication skills

Strategic thinking

Stakeholder influence

Education

Bachelor's degree

ASA or FSA credential

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.

Position Summary

Join a high-performing actuarial team supporting CVS Health and Aetna’s government services group pharmacy business. This Lead Director role supports the fully-insured business by applying deep analytical expertise, actuarial judgment, and strategic leadership to pricing, projections, and complex business decision-making. The role leads a team responsible for supporting large group clients and the broader portfolio, while also providing strategic support for the growing unbundled population. This leader will collaborate across internal and external stakeholders, translate complex financial and legislative developments into clear business implications, and help shape sound, forward-looking business strategies.

Key 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

Required Qualifications

• Bachelor’s degree along with 8+ years of relevant actuarial or healthcare-related analytical experience
• ASA or FSA credential required
• Strong communication and relationship-management skills, with the ability to translate complex actuarial and financial concepts for a range of audiences
• Proven track record of driving results through cross-functional collaboration
• Demonstrated ability to apply analytical rigor, sound judgment, and strategic thinking to complex business challenges
• Experience influencing stakeholders and contributing to discussions with senior leadership
• Demonstrated ability to lead projects, manage competing priorities, and deliver high-quality work within deadlines

Preferred Qualifications

• Experience with Medicare Part D, Medicare Advantage, or other government services business
• Experience evaluating legislative or regulatory changes and translating them into business implications
• People leadership experience, including coaching, developing, and mentoring team members

Education

Bachelor's degree

This remote role does not support sponsorship at this time.

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.

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 (https://learn.bswift.com/cvshealth-mainland) .

We anticipate the application window for this opening will close on: 11/30/2026

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

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace.