Senior Actuary – Network

This is a fully remote position, open to applicants in Texas.

📋 Description

• Deliver financial tools and analytics to aid network strategy that aligns with market and business growth objectives.

• Cultivate a comprehensive understanding of market dynamics while establishing cross-functional partnerships with network, MEU, and commercial actuarial teams.

• Create a quarterly review process for market-level discounts.

• Update Regional Leads and Chief Network Officers on benchmarking modifications, gaps, and areas under pressure for future negotiations.

• Provide insights from the field regarding the effects and timing of new negotiations.

• Enhance contract negotiation strategies through data-driven recommendations for MedRx and Behavioral Health.

• Assist Aetna Whole Health / APCN Plus, joint ventures, and narrow network pricing throughout Commercial market segments.

• Validate and improve pricing by utilizing trend analysis, PCRs, and area factors during the Large Group Rate Review.

• Develop tools and analyses to support Priority Markets and Strategic/Enhanced Providers.

• Manage state-specific standard contracts by selecting a competitive fee schedule that is consistent across state lines.

⛳️ Requirements

• A Bachelor's degree is mandatory.

• A minimum of 5 years of experience in actuarial and/or analytical roles is required.

• Strong technical, analytical, and financial capabilities are essential.

• ASA designation is necessary.

• Excellent written and verbal communication abilities are required.

• Experience in programming with SQL, SAS, Python, or R is needed.

• Ability to deliver exceptional customer service to both internal and external stakeholders.

• Capable of thriving in a dynamic environment with competing priorities and deadlines.

• Strong critical problem-solving skills are required.

• Ability to generate innovative ideas, think strategically, and creatively address ambiguous problems.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources that support physical, emotional, and financial well-being.

• CVS Health bonus, commission, or short-term incentive program.

• Equity award program.