Lead Director; Actuarial - Medicare Part D

CVS Health • Atlanta, GA

4d

About The Position

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. Position Overview: The Lead Director drives strategic market support, continuous improvement, and transformation across actuarial, pricing, and benefit design functions for Individual Medicare Part D (MAPD/PDP) offerings. This director leads technical, operational, and people excellence in a highly regulated environment.

Requirements

• Bachelor's degree along with 10+ years of actuarial experience
• ASA or FSA required
• Prior Medicare Part D, pharmacy or Medicare bid experience required
• Demonstrated leadership and project management experience
• Prior people leadership experience
• Demonstrated experience in reviewing regulatory actions and adapting to uncertainty and ambiguity
• Strong communication skills
• Strong technical background

Nice To Haves

• Strong collaboration skills working across various teams
• Strong organizational skills
• Strong analytic skills, skilled problem solver
• Ability to thrive in a constantly evolving environment with competing priorities and deadlines
• History of improving processes and driving efficiency

Responsibilities

• Manage, develop, and inspire a team of direct reports, cultivating a culture of high performance and professional growth.
• Serve as the primary relationship leader for external vendors, overseeing the development process for Aetna’s Part D Bids and managing vendor performance.
• Lead desk review and bid audit coordination with external vendors and CMS.
• Provide strategic support through regulatory changes, controlling for selection risk.
• Lead alternative benefit modeling, scenario testing, and demonstration project analyses, influencing plan design and market positioning.
• Oversee comprehensive MAPD/PDP landscape reviews and synthesize competitive trends and regulatory shifts.
• Coordinate with business partners to ensure accurate pricing and compliant Medicare Part D Bids.
• Develop and maintain actuarial assumptions—including but not limited to risk score coding, membership, population change, and manual assumptions—ensuring technical rigor and defensibility throughout the pricing process.
• Clearly communicate complex findings and process changes to executive and non-technical audiences.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 5,001-10,000 employees