Manager, Actuarial - Employer Group Waiver Plan
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 Summary CVS Health is seeking a creative, analytical, and collaborative actuarial professional to support Self-Funded Employer Group Waver Plan clients. This role will apply actuarial expertise, financial modeling, and actuarial judgment to develop pricing strategies, forecast plan performance, evaluate financial risk, and assess the impact of evolving Medicare Part D regulations. The position is responsible for developing projections, conducting experience studies and Book of Business (BOB) analyses, and generating data-driven insights that support client and enterprise decision-making. This role will have the opportunity to become the Actuarial point person for at least one large EGWP client with recurring reporting and projections. The successful candidate will partner closely with Sales, Rebate Operations, Underwriting, Clinical, Formulary, and the broader Medicare Part D team to deliver actuarial analyses and strategic recommendations that drive profitable growth, financial sustainability, and client success. This individual will leverage actuarial methodologies, predictive analytics, and emerging experience monitoring to evaluate business performance and support pricing, forecasting, and strategic initiatives.
Requirements
- Bachelor's Degree along with 3+ years relevant actuarial experience with: Strong communication skills, Strong analytical skills
- Associate of the Society of Actuaries (ASA), or demonstrated progress toward actuarial credentials.
Nice To Haves
- Coding Experience.
- Knowledge of pharmacy benefits and formularies.
Responsibilities
- Ability to apply actuarial standards of practice (ASOPs) and sound actuarial judgment to complex business decisions.
- Experience performing experience analyses, assumption setting, and profitability studies.
- Help develop pricing strategies and money-saving options that align with customer needs.
- Support analysis related to Medicare Part D reform and help educate business partners on potential impacts.
- Partner with Underwriting, Sales, and Account teams on complex new business and renewal cases.
- Meet with clients, as needed, to explain economic implications and pricing considerations.
- Complete and/or oversee studies used to set assumptions in pricing models.
- Deliver timely, accurate, and high-quality analyses and recommendations.
- Work independently while collaborating effectively across teams.
- Identify issues that could materially affect financial results and develop sound, unbiased recommendations.
- Apply technical expertise and critical thinking to solve business problems.
- Mentor less experienced team members and support team development.
Benefits
- medical, dental, and vision coverage
- paid time off
- retirement savings options
- wellness programs
- other resources, based on eligibility
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What This Job Offers
Job Type
Full-time
Career Level
Manager
