Executive Director, Actuarial - Medicaid Network

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviorsâ„¢ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position Summary 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. Aetna is recruiting for an Executive Director, Actuarial who will be responsible for understanding and driving action on Medicaid Network Insights and curating support for this important line of business. 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. You will make an impact by: Achieving profitability and membership goals with business partners by contributing to strategies and executing them. Enabling 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. Participating in state specific RFP conversations. Identifying core issues and leveraging colleagues/network to solve them. Navigating several data points, possibly contradictory, and rationalizes recommended course of action, recognizing risks and opportunities. Works with different areas to understand those data points. Recommends logical actions based on data and business acumen that weighs the pros and cons of calculated risks. Forming own opinions based in logic and business sense and having the flexibility to adjust as new ideas are presented, ie. shows a great balance of confidence, open-mindedness, and modesty. Ability for divergent thinking for brainstorming and connecting many ideas and ability for convergent thinking to ensure a recommended course of action and execution. When ideas do not work, have the perseverance to move forward and inspire their team to adjust. Building and facilitating a team environment of trust to foster collaboration and teamwork. Develops and empowers sharing ideas across the organization. Influencing resources within and outside of direct control to complete projects. Supporting 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. Qualifications The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to many aspects of the company's business, as well as significant interaction with Medicaid business leaders. The candidate will be expected to have the following key attributes: 10+ years actuarial and/or health insurance experience. Expert knowledge of Medicaid products. 5+ years of management experience required. Broad experience with all actuarial functions. Adept at execution and delivery (planning, delivering, and supporting) skills. Experience working in a highly matrixed environment. Advanced Excel application design skills, with ability to pull/manipulate data using SQL. Ability to maintain a high degree of confidentiality. Ability to conceptualize new product services and new financial models. Possess an Executive Presence to present to internal and external customers. Mastery of growth mindset (agility and developing yourself and others) skills. Ability to work Hybrid Model (in office Tuesday / Wednesday / Thursday) from the Aetna office. Demonstrated a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias. Education Bachelor's degree or higher in mathematics, actuarial science, or closely related field. ASA or FSA designation preferred. Pay Range The typical pay range for this role is: $131,500.00 - $303,195.00 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ('PTO') or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits CVS Health (We anticipate the application window for this opening will close on: 09/30/2024 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2024-11-02