Senior PBM Underwriting & Pricing Analyst

CVS Health; Wyoming (MI); On-site; USD 47,000 - 122,000; Full time

Job summary

CVS Health is seeking an Underwriting Sr. Analyst to lead financial analysis and pricing strategy within PBM and healthcare enterprise pricing.

You will work with Caremark and Aetna teams to design pricing, support underwriting decisions, and implement pricing changes with accuracy and speed. The role emphasizes deep PBM economics knowledge, data-driven decision making, and collaboration with Sales, Finance, and Legal to optimize client value and margins.

Qualifications

• 3 years in a health plan actuarial role, PBM financial analysis or underwriting role.
• Experience with Caremark underwriting models is a plus.
• Strong analytical and communication skills for pricing strategy.

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 experience

PBM knowledge

Pricing analysis

Financial modeling

Education

Bachelor's degree in mathematics, finance, statistics, actuarial science or other risk management or data related fields or equivalent experience

Tools

Excel

Job description

CVS Health is seeking an Underwriting Sr. Analyst to lead financial analysis and pricing strategy within PBM and healthcare enterprise pricing.

You will work with Caremark and Aetna teams to design pricing, support underwriting decisions, and implement pricing changes with accuracy and speed. The role emphasizes deep PBM economics knowledge, data-driven decision making, and collaboration with Sales, Finance, and Legal to optimize client value and margins.