Senior Manager, Actuarial (IC) Self Insured Discount Team

CVS Health•Atlanta, GA

22h•$118,450 - $260,590

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 Looking for an individual with strong analytic skills and creative insights who can operate independently to manage a variety of open ended analyses in the discount / unit cost and medical management spaces, in support of Aetna’s self-insured value proposition and customers.

Requirements

Bachelors degree along with 5+ years of actuarial and/or analytical experience with strong technical, analytical, and financial skills.
ASA designation.

Nice To Haves

Operates independently and has critical thinking capabilities.
Experience in discounts, discount guarantees, performance guarantees, or Medical Management Modeling.

Responsibilities

Perform detailed actuarial and financial analyses to evaluate the impact of various data and discount methodologies on UDS submissions.
Conduct both ad hoc and recurring studies of discount impact and reporting approaches to support strategic decision-making and maximize competitive positioning within the market.
Provide insights and recommendations on data submission strategies based on changing market dynamics, regulatory requirements, and competitor practices.
Partner with Data Science, Underwriting, Product, and business stakeholders to translate program outcomes, ROI studies, and engagement metrics into measurable and achievable guarantee structures.
Assess the financial risk and volatility associated with proposed guarantees through the aforementioned collaboration.
Develop performance targets, payout methodologies, and guarantee frameworks that appropriately balance market competitiveness and financial risk.
Collaborate with internal partners to refine program designs, reduce guarantee volatility, and strengthen the demonstration of program value by valuating the impact of assumption changes, population exclusions, and methodology adjustments to ensure guarantee integrity and consistency.
Maintain and update performance guarantee documentation, standards, and governance materials, including PADUs and related underwriting guidelines.
Serve as a subject matter expert, providing actuarial judgment on proposed guarantee modifications, client-specific exceptions, and program design changes.
Own and maintain the Medical Management savings modeling tools used by Underwriting and Product teams.
Enhance model functionality through the addition, removal, and refinement of medical management programs, including care management, maternity, oncology, and other clinical initiatives.
Monitor program performance and savings outcomes annually to ensure model assumptions remain current and accurate.
Serve as the primary resource and power user for underwriting teams, providing training, support, and guidance on model utilization and interpretation of results.