Senior Actuary - Predictive Analytics

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Seeking a leader to fill a role on the predictive analytics team within the Aetna Commercial Actuarial Department.  The ideal candidate will bring knowledge in predictive modeling, data science, and actuarial science within the healthcare industry.  With the ability to reframe vague but mission-critical business objectives into empirical problems, you can address them with machine learning and statistical modeling techniques. You will lead strategic development and operational execution of predictive analytics initiatives that drive data-driven decisions, enhance risk assessment, and improve overall financial and health outcomes.  This role will involve collaboration across multiple departments including actuarial, underwriting, data science, and IT, to integrate advanced analytics into business processes and support the organizational growth and profitability goals.

As an innovative and strategic advisor

·         Develop and execute predictive analytic strategies aligned with the company’s business goals, particularly in risk management and claims management to better understand and accurately price commercial health risk.

·         Stay informed on industry trends, emerging technologies, and regulatory requirements to ensure we are both competitive and compliant.

·         Influence organization strategy through data-driven insights and predictive modeling.

·         Continuously monitor, evaluate, and improve methodologies, processes, and tools to maintain a cutting edge analytics advantage.

​Predictive modeling and data science acumen

·         Lead and guide teams in building, testing, deploying predictive models for various aspects of health insurance such as claims prediction, underwriting, and customer lifetime value forecasting.

·         Apply machine learning, AI, and statistical modeling techniques to extract actionably insights from large and complex healthcare datasets.

·         Ensure high model accuracy, stability, and performance to support the business.

Joining forces and inspiring trust

·         Work closely with actuarial, data science, underwriting, and claims to identify opportunities where predictive analytics can solve business challenges or create new value.

·         Partner with IT and data engineering teams to optimize data pipelines and ensure robust data infrastructure to support analytics initiatives.

·         Serve as a trusted advisor for senior leadership and stakeholders, presenting insights and recommendations in a clear and actionable manner.

Required Qualifications

·         5+ years of related actuarial work experience

·         ASA (Associate of the Society of Actuaries) or FSA (Fellow of the Society of Actuaries)

·         Prior healthcare experience

·         Strong understanding of commercial health insurance, risk adjustment, underwriting.

·         Experience in programming languages such as Python, R, or SQL.

Preferred Qualifications

·         Proven knowledge in machine learning, AI, and s