VP, Planning & Pharmacy Analytics

Boca Radiology Group; Tallahassee (FL); Remote; USD 220,000 - 320,000; Full time

Job summary

A leading health solutions company seeks an experienced Actuary to forecast claims costs and enhance pharmacy analytics. This strategic role involves collaborating across departments, ensuring accurate forecasting, and presenting insights to leadership. A commitment to diversity and innovation is essential for candidates.

Benefits

Medical, dental, and vision benefits

401(k) retirement savings plan

Employee Stock Purchase Plan

Paid Time Off (PTO) and paid holidays

Education assistance and free development courses

Qualifications

• 10+ years of relevant Actuarial experience required.
• Strong healthcare business knowledge and collaborative skills.
• Member of American Academy of Actuaries required.

Responsibilities

• Accountability for medical and pharmacy claim forecasts.
• Drive best practices for forecasting and align definitions.
• Present trend forecasts to executive leadership.

Skills

Healthcare business knowledge

Collaborative skills

Innovative thinking

Effective communication

Education

Bachelor's degree

Member of American Academy of Actuaries (MAAA)

FSA preferred

Job description

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

This position is responsible for forecasting claims costs and expanding Aetna's pharmacy analytics capabilities. This role includes:

• Accountability for medical and pharmacy claim forecasts for all Aetna lines of business
• Drive best practices with respect to forecasting. Align approach and definitions across the business segments.
• Review current trend forecasting approach, recommend enhancements, and drive changes with an eye towards greater consistency and enhanced accuracy of forecasts.
• Ownership of Aetna's consolidated trend package which outlines line of business trend forecasts, key assumptions, and drivers of trend in support of the annual budget and quarterly forecasts.
• Build-out capabilities to forecast major cost categories along with establishing underlying unit cost and utilization assumptions.
• Responsible for presentation of trend forecasts to executive leadership and cross-functional partners, including design of materials to support these reviews.
• Collaborate with Medical Economics and business actuaries to gain alignment and drive change.
• Support development of medical and pharmacy (incl. Part D) pricing trend assumptions for all segments, collaborating with business actuaries to understand trend drivers and normalization factors, and engaging Caremark to provide insights on pharmacy outlook
• Partner with Network and Clinical leadership to ensure alignment of assumptions with expectations and operational goals
• Collaborate with Aetna Pharmacy to support/drive pharmacy initiatives, review emerging pharmacy trends, and identify action items.
• Support analysis of intercompany agreements, formulary and policy changes, coordinating with Aetna Pharmacy, Enterprise Pricing, Caremark, and business actuaries/leaders to understand impact on Aetna financials and competitive positioning.
• Coordinate and respond to ad hoc requests in support of quarterly earnings, board requests, etc.
• Remote is with travel once a month to Hartford

Qualifications

The candidate will have a strong work ethic, be a self-starter, and be highly productive in a dynamic, collaborative environment. The candidate will be expected to have the following key attributes:

• 10+ years of relevant Actuarial experience
• Healthcare business knowledge required and expertise will be valued
• Strong collaborative skills and experience working in a matrixed organization
• Innovative thinker
• Experience in anticipating customer needs and requirements as well as facilitating and negotiating using tact and diplomacy.
• Demonstrated success in communicating effectively with internal and external constituents.
• Align with the Heart at Work Behaviors of CVS Health - Put people first; Join forces; Inspire Trust; Rise to the Challenge; Create Simplicity
• Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.
• Travel as needed for the business

Education

• Bachelor's degree
• Member of American Academy of Actuaries (MAAA) required
• FSA preferred

The typical base pay range for this role is:

$220,000.00 - $320,000.00

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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 06/06/2025

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