Actuary - Commercial Large Group Trend & Rate Review at CVS Health

Hartford, Connecticut, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Requirements

Bachelor's degree or equivalent experience
3+ years of actuarial experience
ASA (Associate of the Society of Actuaries) designation preferred (or close to ASA)
Strong technical, analytical, and financial skills
Excellent verbal and written communication skills
Ability to think creatively and use multiple data sources to assess and develop business strategies
Ability to collaborate with experts from other teams to better understand issues/drivers and how/why the impact may differ by line of business
FSA (Fellow of the Society of Actuaries) or actively working towards FSA designation (preferred)
Ability to thrive in a constantly evolving environment with competing priorities and deadlines (preferred)
Ability to collaborate with key stakeholders to formulate recommendations and course of actions (preferred)

Responsibilities

Serve as a member of the functional Actuarial team that works on Large Group Trend and Rate Review
Provide local market actuarial support to the Central Region
Build out trend analytics, documentation, and communication to support market actuaries in assumption setting during the large group rate review
Lead continuous improvement and education as it relates to trend setting
Take learnings from various internal discussions related to trend and communicate those learnings to the broader large group pricing actuarial team
Seek out external resources to help understand macro drivers of trend
Participate as a critical team member to help coordinate the National Large Group Rate Review process
Provide valuable feedback on the Rate Review process to help develop and implement best practices for future cycles including but not limited to the trend setting process
Support the Central Region as an actuarial subject matter expert for South Central (TX, OK, NM) markets
Collaborate with the Plan President, Sales, Finance, Underwriting, Network, Contracting, and Product to develop market specific growth strategies while maintaining enterprise alignment
Proactively monitor financial performance and provide observations/insights into deep dives
Participate in the Implementation and Forecasting/Budget discussions
Oversee the Large Group Rate Filings/DOI objections when applicable
Take accountability to ensure market specific requests and deliverables are met in a timely and responsive manner
Meet with the market to discuss technical results including but not limited to rate actions, trend and prior carrier relativity factors, and area factors

Skills

Trend Analytics

Rate Review

Assumption Setting

Financial Analysis

Forecasting

Budgeting

Underwriting

Pricing Strategy

Actuarial Modeling

Market Analysis

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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