Senior Analyst, Actuarial (ADP)

CVS Health

9d

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. Job Description Summary Support CVS Health's financial integrity with sound pricing and risk management practices. The Medicare Actuarial Pricing team is responsible for anticipating and recognizing matters that materially affect financial integrity and making sound, unbiased reports on these issues. Team members collaborate closely throughout the year with market business partners in addition to the broader actuarial team. A Brief Overview Senior Analysts on the Medicare Actuarial team leverage strong technical skills to analyze data and pricing models, communicate results and solutions, and demonstrate an advanced understanding of actuarial concepts and business acumen. Senior analysts are expected to manage their priorities within pre-established overall deadlines and complete tasks independently with some direction from supervisor. What you will do Develops and communicates pricing model results and strategies. Develops and validates actuarial assumptions, methodologies, and models by ensuring adherence to actuarial standards and guidelines, such as those set by the Society of Actuaries (SOA). Conducts actuarial analysis to assess the financial risks and implications of healthcare programs, insurance products, and benefit plan designs. Completes financial forecasting and projection analysis to estimate future healthcare costs, revenue, and profitability. Analyzes claims data to assess patterns, trends, and cost drivers and identifies opportunities for cost containment, fraud detection, and quality improvement in claims processing and reimbursement. Assesses impacts of new risk-sharing contracting terms and forecasts potential payments associated with value based contracts Under general supervision, provides accurate and timely financial information to internal stakeholders, external auditors, and regulatory bodies. Encourages team members to explore innovative solutions and approaches to operational challenges. Identifies opportunities of areas of concern and recommends corrective actions to management for review and resolution. Progresses through rotations and exam completion in accordance with ADP guidelines.

Requirements

• 2-5 years work experience
• 2 SOA EXAMS passed
• 1 year experience in analytic experience
• Experience working with standard Microsoft Office product suite.
• Working knowledge of problem solving and decision-making skills
• Demonstrated success in collaborating with others to meet/exceed expectations.
• Bachelor's degree

Responsibilities

• Develops and communicates pricing model results and strategies.
• Develops and validates actuarial assumptions, methodologies, and models by ensuring adherence to actuarial standards and guidelines, such as those set by the Society of Actuaries (SOA).
• Conducts actuarial analysis to assess the financial risks and implications of healthcare programs, insurance products, and benefit plan designs.
• Completes financial forecasting and projection analysis to estimate future healthcare costs, revenue, and profitability.
• Analyzes claims data to assess patterns, trends, and cost drivers and identifies opportunities for cost containment, fraud detection, and quality improvement in claims processing and reimbursement.
• Assesses impacts of new risk-sharing contracting terms and forecasts potential payments associated with value based contracts
• Under general supervision, provides accurate and timely financial information to internal stakeholders, external auditors, and regulatory bodies.
• Encourages team members to explore innovative solutions and approaches to operational challenges.
• Identifies opportunities of areas of concern and recommends corrective actions to management for review and resolution.
• Progresses through rotations and exam completion in accordance with ADP guidelines.

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: Mid Level
• Number of Employees: 5,001-10,000 employees