Description

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.

Position Summary

This position manages and designs the financial models and metrics as well as assists with target setting for PCP Focused Medicare Value Based Contracts (VBC). The role will use Actuarial modeling to understand the value created by our VBC Medicare collaboration models as well as any potential financial risk to our provider partners associated with Medicare pricing or CMS regulations. This role will assist our local market contracting teams as well as our VBC national PCP team with any financial modeling needed to help negotiate with our external provider partners. The role will develop the strategy for expansion/revision of existing Medicare VBC models as well as presenting financial results/risks to leadership. This role will also oversee a broad range of key business elements and lead high impact projects to analyze and improve our VBC position in the market, drive business growth through new and innovative VBC arrangements, and collaborate with various business units and levels of leadership both internal and external.

The colleague will:

• Lead collaboration with business partners to analyze the impact of Medicare pricing changes or regulatory reform on our provider partner financials
• Collaborate with cross-functional business partners in Actuarial, Finance, VBC national contracting team, Local Market contracting teams, and legal to achieve desired results
• Develop/Revise/Evaluate and implement PCP Medicare Value-based care models and engage with external provider partners to assist in negotiating Value Based contract terms
• Take full ownership of assigned projects, manage and collaborate with others to meet deadlines and achieve goals
• Create financial performance presentations with actuarial data and report key findings to support key decision-making stakeholders
• Effectively communicate, collaborate, and share results across teams
• Anticipate and recognize matters that materially affect financial results and develop sound, unbiased recommendations on how to resolve these matters
• Pull, clean, and analyze large datasets from various sources to support actuarial analyses and provide the foundation for data-driven decision making

Required Qualifications

• Bachelor's degree along with 3+ years related experience
• ASA (Associates of the Society of Actuaries) or near ASA
• Prior Healthcare experience
• Experience with Microsoft Office suite, especially Excel
• Experience with SQL, working with large and detailed data sets
• Strong communication skills
• Strong analytic and time management skills
• Demonstrates success in collaborating with others to meet/exceed expectations

Preferred Qualifications

• Previous Medicare pricing experience is a plus (Individual, Group or PartD)
• Experience with Value-Based contracting
• Ability to remain flexible with ever changing priorities
• Strong collaboration skills working across various teams
• Ability to communicate effectively with all levels

Education

Bachelor's Degree; equivalent years of related professional work experience may substitute

Anticipated Weekly Hours
40

Time Type
Full time

Pay Range

The typical pay range for this role is:

$92,700.00 - $203,940.00

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 https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 09/26/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.