Senior Analyst, Underwriting

CVS Health•Washington, NV

1d•$46,988 - $122,400

About The Position

CVS Health is hiring a Senior Analyst, Underwriting to perform financial analysis and underwriting, supporting pricing activities that retain and grow pharmacy lives and advance network and formulary pricing strategies. The role manages complex Pharmacy Benefit Management (PBM) pricing strategies and deployment for CVS Health Enterprise, including PBM and Aetna, and advises Aetna Underwriting on pricing for downstream customers. The position reports to the Sr. Manager of PBM Underwriting. The successful candidate will develop expert knowledge of PBM and health plan insurance economics, understand client business goals, and use logic and analytical skills to independently address business questions and communicate findings, methodologies, and estimated outcomes. The role also drives process improvements and develops or enhances tools and processes to support current and prospective client pricing. Familiarity with Caremark underwriting models, EOS, and Fee Authorization Form (FAF) systems would be beneficial.

Requirements

At least 3 years in a health plan actuarial role, PBM financial analysis or underwriting role, or comparable industry experience.
Bachelor’s degree in mathematics, finance, statistics, actuarial science, another risk management or data-related field, or equivalent experience.

Nice To Haves

Prior PBM/Health Plan or PBM/Employer experience.
Actuarial experience and actuarial certifications.
Strong technical skills, particularly in Excel.
Experience with Caremark underwriting models and EOS, and Fee Authorization Form (FAF) systems.

Responsibilities

Assess risk and develop recommendations to maximize client value while retaining margin first in the PBM and second in the Enterprise.
Develop pricing recommendations for multiple lines of business based on in-depth competitive analysis.
Assist Aetna Underwriting leadership with downstream pricing by providing segment-specific data.
Complete tasks in the Caremark Underwriting models.
Modify Fee Authorization Forms (FAFs) appropriately.
Conduct ad hoc analysis to support internal and client requests.
Develop and maintain relationships with Sales and Account Management.
Work with Caremark and Aetna Finance partners to assist with margin budget development and validation.
Create and update complex Pricing Commitment Documents to reflect Caremark’s pricing and contract terms for each business segment.
Advise Caremark Legal as the Underwriting subject matter expert during contract negotiations.
Provide ad hoc analysis and advise on implementation scenarios related to regulatory changes.
Work with internal partners to understand downstream implications of proposed pricing strategies and facilitate seamless, accurate, and timely implementation.
Analyze issues and make recommendations when information is incomplete, finding solutions with minimal guidance.
Acquire and maintain leading-edge knowledge of PBM plan management strategies and solutions.
Work independently and collaboratively in a fast-paced environment while managing tight deadlines.