Senior PBM Underwriting & Pricing Analyst

CVS Health; Lorida (FL); On-site; USD 47,000 - 122,000; Full time

Job summary

CVS Health in the United States seeks an Underwriting Sr. Analyst to lead financial analysis and underwriting for PBM and enterprise pricing strategies. You will work with CVS Health and Finance leadership to drive value through pricing decisions across Caremark and Aetna teams.

The role emphasizes building expert PBM economics knowledge, delivering data-driven recommendations, and partnering with Sales, Account Management, and Legal to implement contracts and regulatory changes.

Qualifications

• 3 years in a health plan actuarial role, PBM financial analysis or underwriting role, or comparable industry experience.
• Prior PBM/Health Plan or PBM/Employer experience
• Actuarial certifications a plus
• Strong Technical skills – particularly in Excel
• Bachelor's degree in mathematics, finance, statistics, actuarial science or other risk management or data related fields or equivalent experience

Responsibilities

• Assessing risk and developing recommendations to maximize client value while retaining margin first in the PBM and second in the Enterprise
• Developing pricing recommendations for multiple lines of business based on in-depth competitive analysis
• Assisting Aetna’s Underwriting leadership to develop pricing for downstream pricing by providing segment-specific data
• Completing tasks in the Caremark Underwriting models
• Modifying FAFs appropriately
• Ad-hoc analysis to support a variety of internal and client requests
• Developing and maintaining relationships with Sales and Account Management
• Developing relationships with Caremark and Aetna Finance partners to assist in margin budget development and validation
• Creating and updating multiple complex Pricing Commitment Documents to reflect Caremark’s pricing and contract terms offer for each business segment
• Advise Caremark Legal as the Underwriting subject matter expert during contract negotiations
• Provide ad hoc analysis and advise on implementation scenarios related to regulatory changes
• Work with internal partners to understand downstream implications of proposed pricing strategy and facilitate seamless, accurate, and on-time implementation
• Ability to analyze and make recommendations on questions or issues when not all the information is available; ability to self-direct to find solutions with minimal guidance
• Acquire and maintain leading-edge knowledge of PBM plan management strategies and solutions
• Ability to work both independently and part of a group in a fast-paced environment and manage tight deadlines

Skills

Actuarial analysis

Underwriting

Financial analysis

Education

Bachelor's degree in mathematics, finance, statistics, actuarial science or related fields

Tools

Excel

Job description

CVS Health in the United States seeks an Underwriting Sr. Analyst to lead financial analysis and underwriting for PBM and enterprise pricing strategies. You will work with CVS Health and Finance leadership to drive value through pricing decisions across Caremark and Aetna teams.

The role emphasizes building expert PBM economics knowledge, delivering data-driven recommendations, and partnering with Sales, Account Management, and Legal to implement contracts and regulatory changes.