Senior Actuary – Network Analytics & Pricing

NACBA; Town of Texas (WI); Hybrid; USD 118,000 - 237,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Retirement savings options

Wellness programs

Paid time off

Job summary

CVS Health is seeking a Senior Actuary in Network Analytics to provide financial tools and analytics to support market-based network strategy. The role focuses on market dynamics, cross-functional relationships with network, MEU, and commercial actuarial teams, and analytics for discounts, pricing, and contracting.

The position requires a Bachelor's degree with 5+ years actuarial/analytical experience and ASA designation, plus programming skills (SQL, SAS, Python, R).

Qualifications

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

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.
• 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.

Skills

5+ years actuarial experience

ASA designation

Education

Bachelor's degree

Tools

SQL

SAS

Python

R

Job description

CVS Health is seeking a Senior Actuary in Network Analytics to provide financial tools and analytics to support market-based network strategy. The role focuses on market dynamics, cross-functional relationships with network, MEU, and commercial actuarial teams, and analytics for discounts, pricing, and contracting.

The position requires a Bachelor's degree with 5+ years actuarial/analytical experience and ASA designation, plus programming skills (SQL, SAS, Python, R).