Lead Director, Actuarial-Cred

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

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 working experience
• Must be an ASA or FSA
• Strong Technical Skills Required (SQL, Python, and Power BI)
• Proven track record of driving for results with multi-functional teams

Preferred Qualifications:

• Prior Commercial, Medicare or Medicaid experience

This remote role does not support sponsorship

Pay Range

The typical pay range for this role is:

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. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

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