Actuary - Network Performance & Execution 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, Health InsuranceIndustries

Requirements

Bachelor's degree along with a minimum of 3+ years of actuarial and/or analytical experience
Strong technical, analytical, communication and financial skills
Experience in Excel and data manipulation
Thrive in a constantly evolving environment with competing priorities and deadlines

Responsibilities

Own and provide support for key narrow network pricing tools
Create and evaluate the appropriateness of pricing assumptions and make recommendations as necessary
Analyze network performance data and suggest cost mitigation strategies across multiple products and segment lines
Develop new processes and tools, adding value to key provider negotiations for superior contracting support
Monitoring performance of existing networks and products to ensure adequate and competitive pricing
Evaluate contract cost outliers and drive for improvement to better position Aetna in the marketplace
Utilize various data sources to identify drivers and potential opportunities to improve performance
Create and foster strong partnerships with multiple business partners

Skills

Key technologies and capabilities for this role

Actuarial AnalysisNetwork PricingFinancial ModelingData AnalysisPricing ToolsNetwork PerformanceValue Based CareAccountable Care OrganizationsProvider RelationsContracting Analytics

Questions & Answers

Common questions about this position

What qualifications are required for this Actuary role?

A Bachelor's degree and a minimum of 3+ years of actuarial and/or analytical experience are required, along with strong technical, analytical, communication, and financial skills, experience in Excel and data manipulation, and the ability to thrive in a constantly evolving environment with competing priorities and deadlines.

What are the preferred qualifications for this position?

Preferred qualifications include 2+ years of healthcare industry experience, experience in VBA, Power BI, Access, SQL, and Google Cloud BigQuery, and excellent written skills.

What is the salary or compensation for this role?

This information is not specified in the job description.

Is this position remote or does it require office work?

This information is not specified in the job description.

What is the company culture like for the network performance team?

The network performance team is a critical asset to the organization, proven agile in evolving to support broader strategy, with expectations to drive value by applying best-in-class service to key stakeholders, and offers opportunities for cross-collaboration with multiple business units.

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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