Senior Actuarial Analyst - Pricing & Risk for Health Plans

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. Join a high-performing actuarial team supporting CVS Health and Aetna's Government Services Medicare Advantage business. The primary responsibility of this role will be to perform pricing and analytic work in support of a department mission to protect Aetna's financial integrity, collaborate with business partners to provide sound risk management advice, anticipate and recognize matters that materially affect financial results, and make sound, unbiased recommendations on these matters. A Brief Overview Performs actuarial functions by applying expanded quantitative skills and analytical methodologies. Leverage strong technical skills to recommend solutions and demonstrate and advanced understanding of actuarial concepts and business acumen. Set own priorities within pre-established overall deadlines. Complete tasks independently with some direction from supervisor. What you will do Develops and communicates pricing models and strategies for Actuarial (ADP) healthcare insurance products and services. Develops and validates actuarial assumptions, methodologies, and models by ensuring adherence to actuarial standards and guidelines, such as those set by the Society of Actuaries (SOA). Conducts actuarial analysis to assess the financial risks and implications of healthcare programs, insurance products, and benefit plans. Completes financial forecasting and projection analysis to estimate future healthcare costs, revenue, and profitability. Analyzes claims data to assess patterns, trends, and cost drivers and identifies opportunities for cost containment, fraud detection, and quality improvement in claims processing and reimbursement. Develops risk mitigation strategies, including reinsurance, risk-sharing agreements, and reserve adequacy analysis. Under general supervision, provides accurate and timely financial information to internal stakeholders, external auditors, and regulatory bodies. Encourages team members to explore innovative solutions and approaches to operational challenges. Identifies opportunities of areas of concern and recommends corrective actions to management for review and resolution. For this role you will need Minimum Requirements 2 SOA Exams passed 3-5 years work experience 1 year experience in analytic experience Demonstrated success in collaborating with others to meet/exceed expectations. Experience working with standard Microsoft Office product suite. Working knowledge of problem solving and decision making skills Education Bachelor's degree Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $79,310.00 - $158,620.00 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. 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 We anticipate the application window for this opening will close on: 11/24/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr CVS Health