Lead Director; Actuarial - Medicaid/Forecast & Trend

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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Join a high-performing actuarial team supporting CVS Health and Aetna's exciting and growing Medicaid business. Support CVS Health's financial integrity by leading actuarial forecasting with sound practices to meet the business needs and ensure reasonable actuarial projections.

A Brief Overview

The primary focus of this director role will be leading actuarial support for the financial forecast modeling of the Medicaid line of business with a secondary focus on trend analysis & development. This role will primarily provide oversight and leadership of activities related to forecasting with a secondary focus on trend normalization and projection.

Fundamental Components

Primary Role (70% time):

• Lead budget and forecast storytelling for the Medicaid business.
• Oversee forecast model development and improvement, and support plan actuaries in understanding forecast projections.
• Drive forecast related analysis including development of key assumptions, evaluation of financial experience and trend drivers.
• Review budget and forecast from a business perspective and ensure sound actuarial projections.
• Identify and support process improvement through automation and process simplification; assure timely and accurate deliverables.
• Manage high visibility and complex projects. Allocate and align resources.

Secondary Functions (30% time):

• Support trend storytelling and prospective trend development for the Medicaid business.
• Track and normalize trends across a very diverse Medicaid footprint.
• Drill into drivers of trend to support managed care savings development and rate advocacy.
• Provide medical expense review support.
• Analyze program changes based on State-directed and internal benefit design changes.
• Use strong critical thinking skills to creatively solve complex business problems and lead team members to do the same.
• Coach, mentor and provide feedback to employees in development of technical skills or subject matter expertise.

Required Qualifications:

• Bachelor's Degree along with 10+ years relevant experience
• Must be an ASA or FSA
• Strong Communication & Collaboration Skills
• Strong Technical Skills Required (SAS, SQL, Python)
• Proven track record of driving for results with multi-functional teams

Preferred Qualifications:

• Prior Commercial, Medicare or Medicaid experience

Pay Range

The typical pay range for this role is:

$100,000.00 - $231,540.00

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: 10/25/2024

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