Job Description
This role can be in any Aetna/CVS office with an office/work from home hybrid OR can be full-time work from home anywhere in the United States.

This individual will own and support the analytics used to update multiple different rating factors, including COVID, area, age/sex, credibility, and participation factors. The role is very project-based, but also has components of cyclical work.

Key responsibilities include:
– Analytics to update key rating factors (mentioned earlier)
– Maintain and update guidance files supporting the annual rate review process
– Subject Matter Expert for development of Line Item Expense (LIE) weights used as part of the benefit factor methodology
– Subject Matter Expert for Large Group rating methodology, liaison with Actuarial Systems for LG rating
– Maintenance of NB and renewal report methodologies
– Support of benefit-related requests that come to the Rating Methodology mailbox
– Multiple ad hoc Rating Methodology-related analytics and projects as needed

Key success factors include:
– Project Management – Successfully manage rating-related projects and initiatives to conclusion. Exhibit innovative use of resources.
– Decision Making- Exercise decision making and make recommendations within scope of authority.

Product & Business Knowledge:
– Assumptions & Data Sources- Demonstrate understanding of existing data sources. Proactively seek out new data sources to support/challenge existing assumptions and recommend alternatives/improvements as necessary.
– Programs, Policies & Processes- Demonstrate understanding of interdepartmental products, programs, processes and policies; research problems and issues and suggest resolution.
– Strategic/Proactive Thinking – Independently formulate improvements to existing processes, tools, and models. Propose and implement improvements.

Technical Proficiency:
– Use of Technology- Develop creative technical solutions to a variety of problems. Stay apprised of technical innovations as potential solutions for actuarial issues and concerns.

– Implementation- Oversee/manage the implementation of updated rating factors.
– Maintenance & Enhancements- Prioritize changes and enhancements to processes, tools and systems.

Communication, Collaboration & Consultation:
– Actuarial Systems – Collaborate effectively with technical actuaries on rating systems as well as those submitting benefit-related requests.
– Senior Actuarial Leadership – Present findings and strategic recommendations to Commercial Actuarial Leadership for approval.


Required Qualifications
– 3+ years actuarial/related work experience.
– Strong technical and analytical skills.
– At least one actuarial exam passed.

COVID Requirements

COVID-19 Vaccination Requirement
CVS 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 Qualifications
– Prior experience with health pricing.
– Advanced skills with Microsoft Excel.
– At least three actuarial exams passed.
– Experience with SQL

– Bachelor’s degree or equivalent experience

Business Overview
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.
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.