Senior PBM Underwriting & Pricing Analyst

CVS Health; Pennsylvania; Hybrid; USD 47,000 - 122,000; Full time

Job summary

CVS Health is seeking an Underwriting Sr. Analyst to lead financial analysis and underwriting for PBM pricing strategies across Caremark and the Enterprise. You will influence pricing decisions by providing deep segment data and collaborating with internal teams.

The role requires strong Excel skills and actuarial or related health-plan experience, with a focus on improving profitability and client value through analytics and strategic pricing.

Qualifications

• 3 years in a health plan actuarial role, PBM financial analysis or underwriting role, or comparable industry experience.

Responsibilities

• Assess risk and develop recommendations to maximize client value while retaining margin first in the PBM and second in the Enterprise.
• Develop pricing recommendations for multiple lines of business based on in-depth competitive analysis.
• Assist Aetna's Underwriting leadership to develop pricing for downstream pricing by providing segment-specific data.
• Complete tasks in the Caremark Underwriting models.
• Modify FAFs appropriately.
• Ad-hoc analysis to support a variety of internal and client requests.
• Develop and maintain relationships with Sales and Account Management.
• Develop relationships with Caremark and Aetna Finance partners to assist in margin budget development and validation.
• Create and update 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

PBM pricing analysis

Underwriting

Financial analysis

Excel

Pricing strategies

Actuarial certifications

Education

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

Tools

Excel

Job description

CVS Health is seeking an Underwriting Sr. Analyst to lead financial analysis and underwriting for PBM pricing strategies across Caremark and the Enterprise. You will influence pricing decisions by providing deep segment data and collaborating with internal teams.

The role requires strong Excel skills and actuarial or related health-plan experience, with a focus on improving profitability and client value through analytics and strategic pricing.