Senior Actuary - Network

Hispanic Alliance for Career Enhancement; Woonsocket (RI); On-site; USD 156,354 - 208,472; Full time

Benefits offered by this job

Comprehensive benefits

Equity/long-term incentive program

Job summary

CVS Health is hiring a Senior Actuary - Network to empower the network analytics team with financial tools and analytics aligned to market growth priorities. You will develop in-depth market dynamics knowledge and collaborate with network, MEU, and commercial actuarial teams to enhance discounts, trend analytics, and pricing and contracting efforts.

The role emphasizes cross-functional work, strategic contract support, and building scalable analytic tools to inform negotiations across regions.

Qualifications

• Bachelor's degree and 5+ years actuarial/analytical experience.
• ASA designation.
• Strong technical, analytical and financial skills.
• Excellent written and verbal communication skills (preferred).

Responsibilities

• Develop quarterly market-level discount review process for regional stakeholders.
• Engage cross-functionally to drive data-driven contract negotiation strategies.
• Support pricing across Commercial market segments and analyze contracting insights.
• Build tools to support strategic contracting for Priority Markets and Providers.

Skills

Actuarial experience

ASA designation

SQL/SAS/Python/R

Communication skills

Education

Bachelor's degree

Job description

Position Summary

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.

The Senior Actuary - Network position within the network analytics team provides the financial tools and analytics to support network strategy in alignment with market/business growth priorities.

The market-specific responsibilities will provide individuals with the opportunity to develop in-depth knowledge of market dynamics and to establish strong cross-functional relationships with key business partners, including network, MEU, and commercial actuarial teams. Additional core areas of focus include network discounts, emerging trend analytics, and pricing and contracting support.

Key responsibilities

• Discounts - Develop a quarterly, market-level discount review process to inform Regional Leads and Chief Network Officers of changes in benchmarking based on the latest view, identifying gaps and pressured areas to consider for future negotiations. Provide meaningful information to the field on the impact and expected timing of new negotiations beyond current consultant benchmarking.
• Emerging Trend Analytics - Engage cross-functionally with Network, MEU, and other teams to drive enhanced contract negotiation strategies using data-driven recommendations for MedRx and Behavioral Health.
• Pricing - provide support for Aetna Whole Health / APCN Plus (Performance Networks), joint ventures, and narrow network pricing across all Commercial market segments. Validate and refine pricing using contracting insights such as trend, PCRs, and area factors during Large Group Rate Review.
• Contracting Support - Build a suite of tools and analyses to provide optimal strategic support for Priority Markets and Strategic/Enhanced Providers. Address a complex and error-prone mix of state-specific standard contracts by selecting a single, competitive fee schedule that is consistent across state lines.

Required Qualifications

• Bachelor's degree along with 5+ years of actuarial and/or analytical experience with strong technical, analytical, and financial skills.
• ASA designation.

Preferred Qualifications

• Excellent written and verbal communication skills.
• Programming (SQL, SAS, Python, R) experience.
• Provide superior customer service to both internal and external constituents.
• Thrive in a constantly evolving environment with competing priorities and deadlines.
• Problem solving skills are critical as many of the concepts are new or in development.
• Ability to generate new ideas, think strategically, and creatively solve problems that are not well defined.

Education

Bachelor's degree required.

Pay Range

The typical pay range for this role is: $118,450.00 - $260,590.00. 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.

Benefits

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.

EEO Statement

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