Medicaid Actuarial Manager: Pricing & Insights

CVS Health Corporation; Massachusetts; On-site; USD 93,000 - 204,000; Full time

Job summary

CVS Health Corporation is seeking an experienced actuary to support Medicaid managed care pricing, performance management, and strategic decision-making. The role partners with market leadership, finance, and operations while guiding actuarial analysts on complex Medicaid analytics.

The ideal candidate balances short-term deliverables with long-term strategic initiatives, independently developing analyses to address business questions in a dynamic healthcare environment.

Qualifications

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

Responsibilities

• Lead actuarial evaluation of state capitation pricing and forecasting for Medicaid managed care programs.
• Analyze drivers of medical cost trends, utilization, enrollment changes, and financial performance.
• Review, challenge, and understand complex analytical methodologies, models, and coding solutions.
• Provide indirect leadership and mentorship for actuarial team members and coordinate work across stakeholders.
• Design, build, document, and communicate new analyses to address evolving business questions.

Skills

SQL proficiency

Microsoft Excel

Healthcare datasets

Education

Bachelor's degree

Job description

CVS Health Corporation is seeking an experienced actuary to support Medicaid managed care pricing, performance management, and strategic decision-making. The role partners with market leadership, finance, and operations while guiding actuarial analysts on complex Medicaid analytics.

The ideal candidate balances short-term deliverables with long-term strategic initiatives, independently developing analyses to address business questions in a dynamic healthcare environment.