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. 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. Responsibilities Develop and communicate pricing model results and strategies. Develop and validate actuarial assumptions, methodologies, and models by ensuring adherence to actuarial standards and guidelines, such as those set by the Society of Actuaries (SOA). Conduct actuarial analysis to assess the financial risks and implications of healthcare programs, insurance products, and benefit plan designs. Complete financial forecasting and projection analysis to estimate future healthcare costs, revenue, and profitability. Analyze claims data to assess patterns, trends, and cost drivers and identify opportunities for cost containment, fraud detection, and quality improvement in claims processing and reimbursement. Assess impacts of new risk‑sharing contracting terms and forecast potential payments associated with value‑based contracts. Under general supervision, provide accurate and timely financial information to internal stakeholders, external auditors, and regulatory bodies. Encourage team members to explore innovative solutions and approaches to operational challenges. Identify opportunities or areas of concern and recommend corrective actions to management for review and resolution. Progress through rotations and exam completion in accordance with ADP guidelines. Minimum Requirements 2‑5 years of work experience. 2 SOA exams passed. 1 year of 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 or exceed expectations. Education Bachelor's degree. Anticipated Weekly Hours: 40 Time Type: Full time Pay Range: $79,310.00 - $158,620.00 Great Benefits for Great People A Affordable medical plan option , 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr
Senior Analyst, Actuarial (ADP) • Springfield, IL, United States
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