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Senior Actuary - Medicaid Revenue Integrity
- CVS Health (Hartford, CT)
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At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
Aetna is recruiting a Senior Actuary on the Medicaid Actuarial Growth and Strategy team. This position will be the point person for the Medicaid Actuarial team's involvement with Revenue Integrity, a crucial revenue-generating initiative for the Medicaid Business Unit. This position's responsibilities will include (but are not limited to):
+ Tracking and providing updates to Medicaid Market and Executive leaders on the performance of revenue integrity initiatives, including Risk Adjustment initiatives.
+ Reviewing emerging results to identify potential risks and opportunities within revenue integrity initiatives.
+ Working with other internal teams to ideate on and size new revenue integrity opportunities.
+ Working with Informatics and supporting market actuaries in the reconciliation of State actuary provided risk adjustment and internal evaluations.
To be successful in this position, you will need an ability to risk-assess complex problems and recommend solutions and communicate effectively with leadership teams. Being able to collaborate effectively with stakeholders across the organization will also be essential to success.
Required Qualifications
* Bachelor's degree along with 5+ years of actuarial or relatable experience
* ASA or FSA credential required
* Prior healthcare experience
* Excellent communication skills
* Strong technical skills; Excel (SAS or SQL)
Preferred Qualifications
* Prior experience in Medicaid, and experience with project management is preferred but not required
* Understanding of Risk Adjustment methodology (in any line of business) is preferred but not required
* Diverse experiences that demonstrate an ability to learn quickly
* Adaptability and ability to prioritize effectively
Education
* Bachelor's Degree is required
Pay Range
The typical pay range for this role is:
$130,295.00 - $260,590.00
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.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 07/07/2025
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.
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