Executive Director, Actuarial - Medicare Network
FlexibleMedicare AdvantagePricing & RatingUW Support & Portfolio ManagementBusiness Intelligence & Reporting
Role Summary
Loading...HIGHLIGHTS
Senior health actuarial leadership role focused on Medicare Network strategy and performance for Aetna/CVS Health (Hartford, CT; hybrid/remote). You will lead a team to drive Medicare bid pricing, network development, and market-level provider performance analysis, partnering with business leaders and participating in state RFPs. ASA required; FSA valued.
JOB DESCRIPTION SUMMARY
- Lead Medicare Network actuarial strategy and target network development
- Drive Medicare bid pricing and CMS fee-schedule analysis
- Enable market teams with data cubes, HCIC insights, and provider performance
- Hybrid or remote role based in Hartford, CT
- Director-level role; ASA required and 10+ years health actuarial experience
DOMAIN EXPERTISE
- Medicare bid pricing
- CMS fee schedule (IPPS/OPPS/Physician) knowledge
- Medicare network development and performance analysis
- Broad health insurance actuarial functions experience
KEY REQUIREMENTS
- 10+ years actuarial health insurance experience
- ASA designation required (FSA valued)
- Approximately 5+ years of people management experience
- Experience with Medicare bid pricing and CMS fee schedules (IPPS/OPPS/Physician)
- Advanced Excel modelling and ability to pull/manipulate data using SQL
TECH STACK
- Excel
