Analyst, Actuarial (ADP)

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary We are seeking an experienced actuarial professional to support Medicaid managed care pricing evaluation, financial performance management, and strategic decision-making. This role requires a strong combination of actuarial expertise, business acumen, technical proficiency, and leadership capability. The successful candidate will serve as a key partner to market leadership, finance, and operational stakeholders while providing guidance and oversight to actuarial analysts supporting complex Medicaid markets. This position is ideal for an actuary with strong project management skills who can balance short-term deliverables and ad hoc requests with long-term strategic initiatives, thrive in a dynamic environment, and independently develop analyses to address emerging business questions. Medicaid Pricing and Actuarial Analysis • Lead actuarial evaluation of state capitation pricing and forecasting for Medicaid managed care programs. • Evaluate and interpret complex state rate-setting methodologies, risk adjustment programs, acuity adjustments, and regulatory requirements. • Assess revenue, medical cost, utilization, and margin drivers to identify emerging trends and business risks. • Summarize and communicate actuarial analysis for business leadership. Strategic Business Support • Partner with market, product, finance, and operations tea

Become a part of our caring community The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Your work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Actuarial Analyst 2, Analytics/Forecasting will report to the Actuary, Analytics/Forecasting. You will play a key role in the Medicare actuarial forecasting process. This position entails the maintenance of the provider revenue and expense projection model and associated tools supporting the projection model. The Actuarial Analyst 2, will be responsible for integrating value-based provider impacts into financial and bid forecasts, managing tools associated with these impacts, and providing guidance on effective risk modeling practices. The Actuarial Analyst 2, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. You will collaborate with stakeholders to understand business needs/issues, troubleshoots problems, conduct root cause analysis, and develop cost effective resolutions for data anomalies. You will understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. You will make decisions regarding own work methods, occasionally in ambiguous situations, and require minimal direction and receives guidance where needed. You will follow established guidelines/procedures. Use your skills to make an impact Required Qualifications Bachelor's Degree Successful completion of at least 3 actuarial exams<

Become a part of our caring community The Actuarial Analyst 2, Analytics/Forecasting supports value-based initiatives within the HealthCare Economics team, partnering across actuarial, finance, analytics, and business teams to develop actionable financial insights and forecasting solutions. This role will play a key part in the design and development of a holistic modeling solution, building new methodologies and frameworks from the ground up to support performance measurement, financial reconciliation, and strategic decision-making across multiple value-based care programs. You work assignments are varied and frequently require interpretation of complex business issues, independent judgment, and the ability to recommend and execute appropriate courses of action with limited guidance. The Actuarial Analyst 2, Analytics/Forecasting will be responsible for analyzing and forecasting claims and revenue trends, developing innovative forecasting methodologies, and translating complex business requirements into scalable analytical solutions. This individual must be able to independently evaluate data, identify gaps, propose holistic approaches, and develop end-to-end solutions that integrate financial, operational, and claims-based insights. Responsibilities include designing forecasting methodologies, establishing reporting metrics, validating model results, and supporting the evolution of value-based care analytics. You will understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. You will make decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Use your skills to make an impact Required Qualifications Bachelor's Degree Successful completion of

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Seeking a Senior Analyst to join the Group Medicare Advantage Actuarial team to assist with Part C analysis & pricing. More specifically, this role will be responsible for the following: Updating assumptions used in pricing Part C Maintaining existing portfolio view reporting Supporting plan sponsor experience refund reconciliations and UW data/reporting needs Collaborating with Underwriting on plan sponsor pricing opportunities for both new business and renewal business Required Qualifications Bachelor’s degree along with 3&#43; years related experience Prior healthcare experience Experience working with large and detailed data sets Preferred Qualifications Strong communication and collaboration skills Solid technical, analytical, and creative problem-solving skills Be organized, data driven, statistically minded and demonstrate an attention to detail Be self-motivated, intellectually curious with a desire to continuously improve processes Be adaptable as business needs and priorities evolve Familiarity with Medicare Part C and/or Group pricing Education Bachelor’s degree or higher in act

Opportunity Overview: We are seeking a Financial Analyst to join our FP&A team. This is a hands-on, detail-oriented role embedded within our Commercial organization. The right candidate brings sharp analytical instincts, a bias for action, and the ability to deliver reliable financial support at a pace that keeps up with a fast-moving sales team and pricing leader What you’ll do: Develop, maintain, and utilize pricing models to forecast profitability, revenue impact, and margin changes Analyze the cost impact of process and product improvements, incorporating them into financial and pricing models Partner with Commercial, Clinical/Operations, and Actuarial teams to develop comprehensive pricing models and present strategic summaries to executive leadership Review and approve deal opportunities, RFP responses, custom pricing structures, and discounting frameworks Gather and compile data points from internal systems to monitor financial performance, metrics, and client profiles Assist with organization-wide strategic projects and provide scenario modeling, serving as the subject matter expert for pricing strategy and inputs Support budget and forecast preparation for the sales and marketing organizations — partnering with the team to build credible, data-backed plans Utilize Adaptive Insights (Workday Adaptive Planning) to manage planning cycles, scenario modeling, and financial reporting with efficiency and accuracy Apply AI-powered analytics tools to automate routine tasks, surface insights faster, and continuously elevate the quality of financial outputs ISMS roles and responsibilities Fair understanding of Information Security practices. Align to the organization policies and procedures. Ensure to get updated with ISMS roles as assigned by the department/process heads. Required Qualifications: Must-haves 3–6 years of pricing, commercial finance, or operations finance experience; healthcare, BPO, or technology-enabled services industry background preferred Adva

Become a part of our caring community Are you ready for a great job? The Value-Based Programs Analyst supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Value-Based Programs Analyst work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action The Value-Based Programs Analyst understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas to include, but not limited to: the Value-Based organization, Enrollment, Product Development, Market Finance, Corporate Finance, Actuarial, Network Contracting, and National Contracting. Analyzes provider financial patterns and trends utilizing excel and/or SQL Updates, maintains, and reviews fee scheduling and pricing structures Thoroughly reviews provider contracts and ensure rates are priced and applied accurately Identifies process recommendations and ensures compliance with government regulations Collaborates and communicates with internal partners of all professional levels within various departments The ideal applicant will have the following skills: Problem Solving Provider Management Relationship management Consumer Experiences Confidentiality Data Analysis Detail-Oriented Written Communication In addition to being a great place to work, Humana also offers industry-leading benefits for all employees, starting your FIRST day of employment. Benefits include: Medical Benefits Dental Benefits Vision Benefits Health Savings Accounts Flex Spending Accounts Life Insurance 401(k) PTO including