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 The Senior Actuary - Network position within the network analytics team provides the financial tools and analytics to support network strategy in alignment with market/business growth priorities. The market-specific responsibilities will provide individuals with the opportunity to develop in-depth knowledge of market dynamics and to establish strong cross-functional relationships with key business partners, including network, MEU, and commercial actuarial teams. Additional core areas of focus include network discounts, emerging trend analytics, and pricing and contracting support. Key responsibilities will include: Discounts – Develop a quarterly, market-level discount review process to inform Regional Leads and Chief Network Officers of changes in benchmarking based on the latest view, identifying gaps and pressured areas to consider for future negotiations. Provide meaningful information to the field on the impact and expected timing of new negotiations beyond current consultant benchmarking. Emerging Trend Analytics – Engage cross-functionally with Network, MEU, and other teams to drive enhanced contract negotiation strategies using data-driven recommendations for MedRx and Behavioral Health. Pricing – provide support for Aetna Whole Health / APCN Plus (Performance Networks), joint ventures, and narrow network pricing across all
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Role overview
Job description
Opportunity Overview: We are looking for a detail-oriented Senior Actuarial Support Analyst to join our Actuarial team. In this role, you will be responsible for evaluating cost-saving initiatives that enhance the efficiency and effectiveness of the prior authorization process. The ideal candidate will have extensive experience in healthcare analytics, financial modeling, and prior authorization, along with a strong strategic mindset and data-driven problem-solving skills. The work will be fast-paced and project-based, with evolving needs - requiring curiosity, flexibility, and grace under pressure. At a growing organization, this is a position that offers the ability to make a substantive mark on the company and its partners with exponential growth opportunities. You will be part of the Actuarial team and develop & maintain cost savings models. This is a remote-first role that may requ
…What they are looking for
Skills & requirements
Department · Actuary
Hiring company
Cohere Health
AI-powered prior authorization and payment integrity solutions that streamline utilization management, reduce costs, and improve care access for health plans.
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