Chief Medicare Actuary

Job DescriptionThe Chief Medicare Actuary will report to the SVP, Actuary and Underwriting of Aetna; he/she will lead the Actuarial and Underwriting team to continue to drive the profitable growth of our $40B Medicare business with sound risk management, pricing, sales support, and reserving practices. This team also supports the development of product designs that meet customer needs and will ensure compliance with all applicable legal and compliance requirements. This team is responsible for anticipating and recognizing matters that materially affect financial integrity and making sound, unbiased reports on these issues.Remote - working East Coast Hours Key accountabilities include: Lead portfolio of Medicare businesses including Group and Individual Medicare Advantage, Prescription Drug Plan (Part D) and Medicare Supplement products Executes on enterprise business strategy and protects CVS Health's financial integrity in support of company mission. Achieves annual growth and margin commitments (fully accountable to address emerging issues) by supporting development of unique products, strategic growth initiatives, unique distribution models, and client mix diversification Establishes and executes risk assessment, pricing, and product offerings necessary to achieve future growth and margin commitments. Leads, hires, develops, and retains skilled talent (mobility, career path, engagement, work-life balance) necessary to execute stated business missions. Oversees broad markets/functions/processes, e.g. multiple territories or functions with national scope and significant influence across the business. Regularly collaborate with internal cross-functional and external stakeholders Participates on work groups/forums representing CVS Health to external constituents. Issues, as needed, Actuarial Communications as defined in the Actuarial Standards of Practice. Partner with head of Medicare business to provide Actuarial leadership to the achieve business growth and financial goals Leverage enterprise capabilities to partner with local markets to achieve financial commitments (membership volume, revenue, and claims), including the development of market pricing strategies to optimize competitiveness and earnings. Delivers customer-focused benefit offerings, with competitive financial components that are easy to understand, implement, and administer. Leverages CVS assets to drive growth and persistency of Medicare products that results in members with long-term engagement in programs that improve their health. Partners with Sales and Product to develop new distribution and benefit offerings that meet evolving needs of plan sponsors, including cross-selling MA products Ensures organizational structure maintains pace with growing business needs, providing opportunities for individual career growth. Conveys a clear sense of CVS Health's core values and business plan. Determines key factors affecting the financial plan and proactively influences those factors to align with CVS Health's goals based on knowledge of the economy, industry trends and marketplace conditions. Influences and institutes change in Actuarial policy or premium rates to maximize profitability while managing risk. Partners with appropriate operational areas to proactively ensure sold products can be implemented and administered based on CVS Health's quality standards and guidelines. Negotiates and influences sound corporate decisions by adhering to established risk management principles. Ensures legal and regulatory compliance.Required Qualifications 15+ years of relevant Actuarial and/or Underwriting experience. Medicare knowledge required and expertise will be valued. Strong people leadership experience Innovative thinker Member of American Academy of Actuaries (MAAA) is required FSA preferred. Proven leadership skills and strong cross-functional relationships with sales and other internal organizations. Experience in anticipating customer needs and requirements as well as facilitating and negotiating using tact and diplomacy. Demonstrated success in communicating effectively with internal and external constituents. Proven ability to negotiate internal and external cross-functional business issues Align with the Heart at Work Behaviors of CVS Health - Put people first; Join forces; Inspire Trust; Rise to the Challenge; Create SimplicityCOVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred QualificationsSee aboveEducationMAAA requiredFSA highly valuedBusiness OverviewAt Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Created: 2024-11-02