Manager, Actuarial (ADP)

CVS Health•Hartford, MA

5d•$92,700 - $203,940

About The Position

We are seeking an experienced actuarial professional to support Medicaid managed care pricing evaluation, financial performance management, and strategic decision-making. This role requires a strong combination of actuarial expertise, business acumen, technical proficiency, and leadership capability. The successful candidate will serve as a key partner to market leadership, finance, and operational stakeholders while providing guidance and oversight to actuarial analysts supporting complex Medicaid markets. This position is ideal for an actuary with strong project management skills who can balance short-term deliverables and ad hoc requests with long-term strategic initiatives, thrive in a dynamic environment, and independently develop analyses to address emerging business questions.

Requirements

Bachelor's degree
3+ years of actuarial experience in or adjacent to managed care or health insurance
Strong SQL and Microsoft Excel proficiency.
Experience working with large healthcare datasets.
Knowledge of actuarial modeling and forecasting techniques.

Nice To Haves

Experience with actuarial pricing, forecasting, reserving, or financial planning functions.
Experience with healthcare data warehouses and reporting platforms.
Experience assessing and explaining drivers of financial performance.
Strong analytical and problem-solving skills with the ability to manage ambiguity and new or complex business questions.
Proven ability to independently manage multiple priorities and competing deadlines.
Data visualization tools such as Power BI.
Ability to generate new ideas, think strategically, and creatively solve problems that are not well defined.
Excellent written and verbal communication skills.

Responsibilities

Lead actuarial evaluation of state capitation pricing and forecasting for Medicaid managed care programs.
Evaluate and interpret complex state rate-setting methodologies, risk adjustment programs, acuity adjustments, and regulatory requirements.
Assess revenue, medical cost, utilization, and margin drivers to identify emerging trends and business risks.
Summarize and communicate actuarial analysis for business leadership.
Partner with market, product, finance, and operations teams to support strategic decision-making.
Provide insight into Medicaid market dynamics, state policy changes, competitive positioning, and business performance.
Evaluate financial impacts of operational and strategic initiatives.
Support development of long-term business strategies through data-driven analysis.
Analyze drivers of medical cost trends, utilization patterns, enrollment changes, and financial performance.
Investigate emerging issues and perform root-cause analyses to explain variances from expectations.
Deliver concise and compelling insights to senior leadership.
Review, challenge, and understand complex analytical methodologies, models, and coding solutions developed by actuarial and analytics teams.
Provide technical oversight and direction to team members working with large healthcare datasets.
Collaborate effectively with analysts and data professionals utilizing SQL and other analytical tools.
Ensure analytical work is appropriately validated, documented, and reproducible.
Provide indirect leadership and mentorship for actuarial team members.
Coordinate work across multiple stakeholders and analytical resources.
Foster accountability, collaboration, and trust with key business partners.
Drive project completion by managing follow-ups, resolving obstacles, and ensuring commitments are met.
Design, build, document, and communicate new analyses to answer evolving business questions.
Identify opportunities to improve existing methodologies, reporting, and analytical processes.
Develop scalable solutions to support increasingly complex business needs.