Medicaid Actuarial Lead

9025 CVS Shared Services Resources LLC; United States; On-site; USD 93,000 - 204,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking an experienced actuarial professional to support Medicaid pricing evaluation, financial performance management, and strategic decision-making. This role partners with market leadership, finance, and operations to deliver data-driven insights and steer complex pricing initiatives.

You will lead actuarial analyses of state capitation, interpret rate-setting methodologies, and provide oversight to analysts handling large healthcare datasets.

Qualifications

• Bachelor's degree and 3+ years actuarial experience in or adjacent to managed care/health insurance.
• Strong SQL and Excel proficiency; experience with large healthcare datasets.
• Knowledge of actuarial modeling and forecasting techniques.

Responsibilities

• Lead actuarial evaluation of state capitation pricing and forecasting for Medicaid programs.
• Support strategic decision-making with market, product, finance and operations partners.
• Analyze medical cost trends, utilization, enrollment, and financial performance.

Skills

SQL

Excel

Healthcare data

Education

Bachelor's degree

Tools

Power BI

Job description

CVS Health is seeking an experienced actuarial professional to support Medicaid pricing evaluation, financial performance management, and strategic decision-making. This role partners with market leadership, finance, and operations to deliver data-driven insights and steer complex pricing initiatives.

You will lead actuarial analyses of state capitation, interpret rate-setting methodologies, and provide oversight to analysts handling large healthcare datasets.