Lead Director, Actuarial - Self Insured

CVS Health • Atlanta, GA

4d

About The Position

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary This Lead Director will drive Aetna’s point of view on the use of Machine Readable Files and Hospital Transparency files with Health Benefit Consultants as well as to help shape strategy in how we create our own Machine Readable files. This individual will both deeply understand the strengths and limitations of these data sources while building collaborative relationships internally and externally to position this data favorably for Aetna. There will also be responsibility for managing a team of 3 that will include responsibility for evaluating and publishing self insured trends and ensuring our customer’s understand our out of network savings value proposition.

Requirements

• Bachelor's degree along with 10+ years of Actuarial and / or Data Analytics experience that includes conducting your own analyses and directing the analyses of others
• Must have prior healthcare experience
• Strong analytical skills, demonstrated ability to understand new data sources and draw out insights
• Experience in cross functional collaborative projects, partnering to create win-win outcomes across departments
• Demonstrated ability to create relationships with both internal and external stakeholders
• Prior management skills, leading a team
• Communication skills that result in influencing outcomes through both education and persuasion
• Proficiency with Microsoft Excel
• ASA or FSA strongly preferred
• Align with the Heart at Work Behaviors of CVS Health – Put people first; Join forces; Inspire Trust; Rise to the Challenge; Create Simplicity

Nice To Haves

• Proficiency and aptitude to learn Sequel coding in the Google Cloud Platform is preferred.
• Align with the Heart at Work Behaviors of CVS Health – Put people first; Join forces; Inspire Trust; Rise to the Challenge; Create Simplicity
• Knowledge of Commercial, Self Insured business space
• ASA or FSA

Responsibilities

• Direct and conduct research on the Machine Readable Files and Hospital Transparency files to understand their content, how they relate to how claims are actually paid and how they relate to data in our UDS discount submissions.
• Manage a team of 3 individual colleagues
• Evaluate Aetna’s self-insured trend performance and provide guidance on how trends should be set for Underwriting use
• Managing the process for producing out of network savings analyses and helping to explain the analysis and value proposition to our customers and consulting partners.
• Build on established Health Benefit Consultant relationships or build new relationships to understand how these consultants are using these data sources for client facing analyses.
• Work collaboratively with internal business partners to improve usability and favorability of how our MRF data is presented in the marketplace.
• Educate consultants on how our data is created and influence how they use our data to create more favorable outcomes for Aetna.

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