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.

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.

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.

• 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

• Prior Commercial, Medicare or Medicaid experience

This remote role does not support sponsorship

The typical pay range for this role is: