Lead Director, Actuarial Cred – Medicaid

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.

At Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health’s unrivaled presence in local communities and their pharmacy benefits management capabilities, we’re joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.

About the role

This is an entirely Medicaid-focused role surrounding delivering on our overarching Medicaid network strategy; it is inclusive of target network development in new geographies, and development of networks to support unique Medicaid member needs.

Responsibilities

• Achieve profitability and membership goals with business partners by contributing to strategies and executing them.
• Enable Network Market leaders to drive Network Performance analysis at a market level – data cubes, HCIC (health care information center), curation of a network, and overall provider performance.
• Participate in state-specific RFP conversations.
• Identify core issues and leverage colleagues/network to solve them.
• Navigate several data points, possibly contradictory, and rationalize recommended course of action, recognizing risks and opportunities. Work with different areas to understand those data points.
• Recommend logical actions based on data and business acumen that weighs the pros and cons of calculated risks.
• Form own opinions based in logic and business sense while remaining flexible to adjust as new ideas are presented, demonstrating a balance of confidence, open-mindedness, and modesty.
• Demonstrate divergent thinking for brainstorming and connecting ideas, as well as convergent thinking to ensure a recommended course of action and execution.
• Persevere when ideas do not work and inspire the team to adjust.
• Build and facilitate a team environment of trust to foster collaboration and teamwork. Develop and empower sharing ideas across the organization.
• Influence resources within and outside of direct control to complete projects.
• Support CVS Health in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve.

Requirements

• Broad experience with all actuarial functions.
• Preferred to have experience leading and influencing others.
• Network background is highly desired.
• Adept at execution and delivery (planning, delivering, and supporting) skills.
• Experience working in a highly matrixed environment.
• Strong experience in growth mindset (agility and developing yourself and others) skills.
• Demonstrated commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.
• Bachelor's degree along with 8+ years of actuarial and/or health insurance experience.
• ASA or FSA required.
• 6+ years of advanced Microsoft Office experience.

Preferred Qualifications

• Medicaid experience.
• Leadership experience with the ability to influence.
• Network background.
• Ability to work independently.

Education

Bachelor's degree required.

Pay

The typical pay range for this role is $144,200.00 - $288,400.00. This pay range represents the 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.

Benefits

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include:

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.