Executive Director, Actuarial - Medicare Network

Position Summary

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.

Key Responsibilities

• Lead Medicare network insight generation and curation support in service of membership and broader line-of-business goals
• Partner with senior business leaders to shape network strategy, inform key decisions, and support execution against Medicare growth and performance priorities
• Enable Network market leaders with actionable market-level performance insights, including provider performance analysis, curation strategy, data cubes, HCIC-based reporting, and related decision support
• Support and influence plan sponsor-specific RFP strategy through actuarial analysis, business judgment, and cross-functional partnership
• Identify the most critical business issues, synthesize root causes, and mobilize the right partners to drive solutions
• Translate multiple, and at times conflicting, data sources into clear, executive-level recommendations that balance risk, opportunity, and enterprise impact
• Build well-reasoned points of view grounded in logic, business acumen, and strategic context, while remaining adaptable as new information emerges
• Lead effectively through ambiguity, helping stakeholders navigate competing priorities and reach clear decisions
• Build trust and foster collaboration across actuarial, network, Medicare, and market teams to drive enterprise alignment
• Influence resources within and beyond direct reporting lines to deliver complex, cross-functional work at scale
• Develop and empower talent by creating an environment that encourages thoughtful challenge, idea-sharing, accountability, and strong execution

Required Qualifications

• 10+ years of actuarial experience in health insurance
• Deep Medicare experience, including Bid Pricing, CMS reimbursement structures such as IPPS, OPPS, and Physician Fee Schedule, and broader CMS knowledge
• Approximately 5+ years of people leadership experience
• Broad experience across actuarial functions
• Demonstrated ability to operate effectively in a highly matrixed environment and influence across diverse stakeholder groups
• Strong execution and delivery skills, including planning, driving work forward, and supporting implementation
• Advanced Excel and SQL skills, including the ability to manipulate data and generate actionable insights
• Strong strategic and business judgment, including the ability to assess tradeoffs, evaluate risk, and recommend a logical course of action

Preferred Qualifications

• Demonstrated ability to build consensus and secure senior-level buy-in on complex, high-impact decisions
• Executive-level influence and storytelling, with the ability to translate actuarial and network insights into clear, compelling narratives
• Strategic agility and comfort operating in ambiguity while maintaining focus on outcomes
• Strong cross-functional leadership and collaboration skills, with a track record of aligning diverse perspectives around a common path forward
• Innovative problem-solving capability, including curiosity, creativity, and the ability to connect disparate ideas into forward-looking solutions
• Experience helping shape new product, network, or financial model approaches

Pay Range

The Typical Pay Range For This Role Is $175,100.00 - $334,750.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.