Job Title

Job DescriptionThis position within the Network Performance and Execution organization provides the financial tools and analytics in support of the network strategy for the North Atlantic territory. The primary areas of focus include network discounts, Accountable Care Organizations (ACOs), and other Value Based Contracts (VBCs). Network Actuary key responsibilities will include: Partnering with the Chief Network Officers (CNOs) to execute on key initiatives that will drive competitive positioning across all network products from broad to ACOs and ensure we implement the right networks and programs with the right partners in a way that creates value for our members, plan sponsors, providers, and Aetna/CVS Health. Ownership of the ACO and narrow network pricing for the North Atlantic territory in support of all Commercial market segments (IVL, Small, Select/Key, National, Public & Labor). This includes performing annual rate reviews in partnership with the Commercial Actuarial market actuaries for existing ACOs as well as participating in business development of new networks and ACOs. Monitor performance of existing networks and products to ensure adequate and competitive pricing that will support our Operating Plan goals for profitability and membership. Broad network discounts continue to be a focus of self-funded plan sponsors in their carrier selection decisions. This role works actively with the local network management teams to understand how our discount submissions reflect on historical contracting efforts, identify potential contract outliers that could impact how our discount is perceived in a market, and work strategically to identify opportunities for contractual improvement. Since discounts are just one measure of a contract, this role actively works with data analytics to ensure transparency and other competitive intelligence at the provider level can be aligned into a wholistic view of our market positioning. Key partners are local network management, Commercial Actuarial, and MEU.Needs/what you get from the role: Ensure connections across the network spectrum are understood - changes in a broad network contract can impact an ACO or performance network Develops visibility and story-telling through presentations at semi-monthly network meetings You will become the go-to resource for network and a trusted advisor to ensure network actions are understood and applied in pricing#AetnaActuaryRequired QualificationsBachelor's degree with 8+ years related work experience Strong technical, analytical, and financial skillsMust have ASA or FSACOVID 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 QualificationsExcellent written and verbal communication skills Programming (SQL, SAS, Python, R) experienceProvide superior customer service to both internal and external constituents. Thrive in a constantly evolving environment with competing priorities and deadlinesProblem solving skills are critical as many of the concepts are new or in developmentAbility to generate new ideas, think strategically, and creatively solve problems that are not well defined.EducationBachelor's degree requiredBusiness OverviewBring your heart to CVS HealthEvery 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 Behaviors 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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.