This role is open to anywhere in the U.S.A.
This individual will act as the Subject Matter Expert for Aetna's benefit methodology.
Key responsibilities include:
- Perform analyses to update factors within the benefit methodology (e.g. induced demand, copay/coins, etc.).
- Develop supporting materials to present changes to senior Actuarial management, including disruption analyses and presentations.
- Coordinate implementation of updates to the methodology in the Aetna Quoting Center (AQC – core source of benefit methodology), AQC Parallel Testing (APT – tool pointing to AQC tables and mimicking methodology, but with batch capabilities), and DEDOOP (Excel representation of AQC calculation).
- Maintain, troubleshoot, update, and answer questions related to DEDOOP and existing tools referencing DEDOOP/AQC: BenPlansBuild, RAD (Rate and ACO Differential), GRABB (General Report Alignment to BenplansBuild), IndexConfigIDtoBenPlan, and AQC Rate Audit Review.
- Support benefit-related questions that come through the LRB Actuarial Rating Methodology mailbox.
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 within scope of authority.
- Coaching – Maintain coaching relationship with 1-2 employees. Provide valuable feedback related to current responsibilities, performance, and career goals/planning.
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 rating processes, tools, and models. Propose and implement improvements.
- 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.
- Development & Implementation- Oversee/manage the development and implementation of rating-related tools and models.
- Maintenance & Enhancements- Prioritize changes and enhancements to processes, tools and systems.
- Testing- Manage testing for changes to processes, tools, and systems.
Communication, Collaboration & Consultation:
- Senior Actuarial Leadership – Present findings and strategic recommendations to Commercial Actuarial Leadership for approval.
- Market Actuarial – Present approved results to Market Actuarial teams and assist with implementation
- 4+ years related work experience
- Strong technical, analytical, and financial skills
- ASA (Associate of the Society of Actuaries) or FSA (Fellow of the Society of Actuaries)
- Prior experience with benefit pricing
Bachelor's degree or equivalent experience
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.
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