Senior Manager, Actuarial

CVS Health

. Lead actuarial evaluation of state capitation pricing and forecasting for Medicaid managed care programs .

Posted 11/6/2026full-timeUnited StatesSenior💰 $130,295 - $260,590 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in actuarial evaluation, pricing, and forecasting for Medicaid managed care programs, with strong proficiency in SQL and Excel. Capable of analyzing healthcare data to identify trends and communicate insights effectively to leadership.

Highest-signal resume keywords

Actuarial ExperienceSQL ProficiencyActuarial ModelingData Visualization ToolsASA Designation

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Actuarial PricingForecasting TechniquesFinancial PlanningHealthcare Data AnalysisRisk Adjustment ProgramsAcuity AdjustmentsRevenue AssessmentUtilization AnalysisMedical Cost TrendsRoot-Cause Analysis

Soft Skills

Excellent Communication SkillsMentorshipProject ManagementCollaborationProblem-Solving

Tools & Technologies

Microsoft ExcelSQLPower BIHealthcare Data WarehousesAnalytical Methodologies

Certifications & Qualifications

ASA Designation

Industry Keywords

Managed CareHealth InsuranceCapitation PricingRegulatory RequirementsFinancial Performance

Tech Stack

Tools & technologies

SQL

About the role

Key responsibilities & impact

Lead actuarial evaluation of state capitation pricing and forecasting for Medicaid managed care programs
Evaluate state rate-setting methodologies, risk adjustment programs, acuity adjustments, and regulatory requirements
Assess revenue, medical cost, utilization, and margin drivers to identify trends and business risks
Summarize and communicate actuarial analysis to business leadership
Partner with market, product, finance, and operations teams on strategic decision-making
Evaluate financial impacts of operational and strategic initiatives
Analyze medical cost trends, utilization patterns, enrollment changes, and financial performance
Investigate emerging issues and perform root-cause analyses
Deliver insights to senior leadership
Review and provide technical oversight of analytical methodologies, models, and coding solutions
Collaborate with analysts and data professionals using SQL and other analytical tools
Ensure analytical work is validated, documented, and reproducible
Provide indirect leadership and mentorship to actuarial team members
Coordinate work across stakeholders and analytical resources
Manage follow-ups, resolve obstacles, and drive project completion
Design, build, document, and communicate new analyses
Improve methodologies, reporting, and analytical processes
Develop scalable solutions for complex business needs

Requirements

What you’ll need

Bachelor’s degree required
5+ years of actuarial experience in or adjacent to managed care or health insurance
ASA designation required
Strong SQL proficiency
Strong Microsoft Excel proficiency
Experience working with large healthcare datasets
Knowledge of actuarial modeling and forecasting techniques
Experience with actuarial pricing, forecasting, reserving, or financial planning functions
Experience with healthcare data warehouses and reporting platforms
Experience assessing and explaining drivers of financial performance
Data visualization tools such as Power BI
Ability to manage multiple priorities and competing deadlines
Excellent written and verbal communication skills

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program
Award target in the company’s equity award program
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being