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Position Summary
Looking for an individual with strong analytic skills and creative insights who can operate independently to manage a variety of open ended analyses in the discount / unit cost and medical management spaces, in support of Aetna’s self-insured value proposition and customers.
Strategic UDS Submission Support
Perform detailed actuarial and financial analyses to evaluate the impact of various data and discount methodologies on UDS submissions.
Conduct both ad hoc and recurring studies of discount impact and reporting approaches to support strategic decision-making and maximize competitive positioning within the market.
Provide insights and recommendations on data submission strategies based on changing market dynamics, regulatory requirements, and competitor practices.
Performance Guarantee Development and Risk Assessment
Partner with Data Science, Underwriting, Product, and business stakeholders to translate program outcomes, ROI studies, and engagement metrics into measurable and achievable guarantee structures. Assess the financial risk and volatility associated with proposed guarantees through the aforementioned collaboration.
Develop performance targets, payout methodologies, and guarantee frameworks that appropriately balance market competitiveness and financial risk.
Collaborate with internal partners to refine program designs, reduce guarantee volatility, and strengthen the demonstration of program value by valuating the impact of assumption changes, population exclusions, and methodology adjustments to ensure guarantee integrity and consistency.
Maintain and update performance guarantee documentation, standards, and governance materials, including PADUs and related underwriting guidelines.
Serve as a subject matter expert, providing actuarial judgment on proposed guarantee modifications, client-specific exceptions, and program design changes.
Medical Management Savings Modeling
Own and maintain the Medical Management savings modeling tools used by Underwriting and Product teams.
Enhance model functionality through the addition, removal, and refinement of medical management programs, including care management, maternity, oncology, and other clinical initiatives.
Monitor program performance and savings outcomes annually to ensure model assumptions remain current and accurate.
Serve as the primary resource and power user for underwriting teams, providing training, support, and guidance on model utilization and interpretation of results.
Required Qualifications
- Bachelors degree along with 5+ years of actuarial and/or analytical experience with strong technical, analytical, and financial skills.
- ASA designation.
Preferred Qualifications
Operates independently and has critical thinking capabilities.
Experience in discounts, discount guarantees, performance guarantees, or Medical Management Modeling.
Education
Bachelors degree required.
Pay Range
The typical pay range for this role is:
$118,450.00 - $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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 08/24/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
