Senior Actuarial Consultant (Cred) - Pharmacy

Job Description
Provide actuarial support for Commercial pharmacy, including:
- Financial review of pharmacy trend drivers
- Segment level Rx reporting and monitoring
- Financial modeling to support Pharmacy product development
- Tracking and monitoring of data for fraud, waste, and abuse
- New tool research and development to assist in accuracy and automation of team's work
- Assist with Rx actuarial help desk questions from underwriting and sales around pricing impact of various Rx items
- Perform rate studies to evaluate new and existing rating factors
- Evaluate impact of state regulations on pharmacy costs
- Support formulary strategy and analytics thru financial modeling and reporting
- Identifying opportunities to lower the cost of care
- Demonstrate understanding of complex actuarial functions and industry related issues.
- Collaborate with pharmacy and actuarial partners.
- Influence, recommend and implement actuarial policy and processes.


Required Qualifications
- Exposure to healthcare actuarial work
- Understanding of healthcare actuarial concepts (i.e. trend, manual rates) and how they impact the business
- Ability to communicate technical information
- Desire to improve processes through automation or new methodologies
- Programming or SQL experience

COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions 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, pregnancy, or religious belief that prevents them from being vaccinated.
  • If you are 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 within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
  • If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications
- Exam progression towards ASA/FSA

Bachelor's degree or higher

Business Overview
At 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.