Lead Director - Actuarial (Plan Support)

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.

Join a high-performing actuarial team supporting CVS Health and Aetna's exciting and growing Medicaid business. Support CVS Health's financial integrity with sound reserving and risk management practices as well as product designs that meet customer needs and pricing that produces returns to shareholders commensurate with the risks undertaken. Actuarial is responsible for anticipating and recognizing matters that materially affect financial integrity and making sound, unbiased reports on these issues.

A Brief Overview

The primary responsibility of this director role will be leading Actuarial market support for the Northeast region's Medicaid contracts (VA, MD, NJ, NY, PA). Within this role, you'll:

• Lead/manage Plan and analytical support to achieve operating plan goals.
• Influence business decisions, anticipate and recognize matters that materially affect financial results and make sound, unbiased reports on these matters.
• Lead Actuarial interactions with Market leads - CEO, CFO, CMO and COO.
• Interact and drive relationships with external partners, including the MCO Actuarial Coalition and the State's Actuarial Consulting firm.

Fundamental Components

• Provides oversight and guidance related to rate negotiations & renewals with respective internal and external constituents. [Travel may be required]. (30% time)
• Develop recommendations and set forecast in collaboration with finance and business partners. (30% time)
• Use strong critical thinking skills to creatively solve complex business problems and lead team members to do the same. (10% time)
• Assure compliance with Medicaid contract and supplemental analysis requests from market leads or the State. (5% time)
• Influence/motivate resources within and outside of direct control to complete projects. (5% time)
• Review assumptions developed by staff from a business perspective and be able to influence senior management to accept alternative recommendations. (5% time)
• Manage high visibility and complex projects. Allocate and align resources. (5% time)
• Coach, mentor and provide feedback to employees in development of technical skills or subject matter expertise. (5% time)
• Review reserve recommendations and communicate to health plan leaders. (5% time)

Required Qualifications

• Bachelor's Degree along with 10+ years relevant actuarial work experience
• Membership in American Academy of Actuaries is required (ASA or FSA).
• Strong Communication & Collaboration Skills
• Strong Technical Skills Required (SAS, SQL, Excel)
• Proven track record of driving for results with multi-functional teams

Preferred Qualifications:

• Prior Commercial, Medicare or Medicaid experience strongly preferred.

Pay Range

The typical pay range for this role is:

$144,200.00 - $288,400.00

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.

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 our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 06/30/2025

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