Senior Actuary - Network
Job
CVS Health
Woonsocket, RI (In Person)
$189,520 Salary, Full-Time
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Job Description
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.
CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace.
- Position Summary
- This position within the network analytics team provides the financial tools and analytics to support network strategy in alignment with market/business growth priorities.
Key responsibilities will include:
+ Discounts - Develop a quarterly, market-level discount review process to inform Regional Leads and Chief Network Officers of changes in benchmarking based on the latest view, identifying gaps and pressured areas to consider for future negotiations. Provide meaningful information to the field on the impact and expected timing of new negotiations beyond current consultant benchmarking. + Emerging Trend Analytics - Engage cross-functionally with Network, MEU, and other teams to drive enhanced contract negotiation strategies using data-driven recommendations for MedRx and Behavioral Health. + Pricing - provide support for Aetna Whole Health / APCN Plus (Performance Networks), joint ventures, and narrow network pricing across all Commercial market segments. Validate and refine pricing using contracting insights such as trend, PCRs, and area factors during Large Group Rate Review. + Contracting Support - Build a suite of tools and analyses to provide optimal strategic support for Priority Markets and Strategic/Enhanced Providers. Address a complex and error-prone mix of state-specific standard contracts by selecting a single, competitive fee schedule that is consistent across state lines.Required Qualifications:
- Bachelors degree along with 5+ years of actuarial and/or analytical experience with strong technical, analytical, and financial skills. ASA designation.
- Preferred Qualifications
- Excellent written and verbal communication skills.
- Education
- Bachelor's degree required.
- Pay Range
- The typical pay range for this role is: $118,450.
- 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.
CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace.
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