Bloomfield NJ

Nashville TN

Remote

Part Qualified

Associate

Qualified

Life

Health

Reporting

Risk

Python

Modelling

Coding

Pricing

Excel

Cigna

This newly created role will support Dental Economics, focusing on analytics related to network/contracting, trend analysis, large case analytics, plan design/product analytics, and more. The role will have one direct report and will be instrumental in establishing a governance committee consisting of leaders from the dental Senior Leadership Team (SLT) to manage the inventory of analytical projects.This position offers the opportunity to work with various matrix partners across the dental organization and influence business decisions and strategies through analytical insights.Key Functions<ul><li>Gain a comprehensive understanding of dental economics, including network/contracting, trend analysis, large case analytics, and plan design/product analytics.</li><li>Design and maintain a comprehensive testing and analytics plan. Perform and oversee the execution of various analytical elements to ensure accuracy and relevance of results.</li><li>Lead the creation and management of a governance committee with leaders from the dental SLT to oversee the inventory of analytical projects.</li><li>Work closely with underwriting and other relevant teams for user acceptance testing and training.</li><li>Collaborate with matrix partners across the dental organization to manage various workstreams, ensuring that all stakeholders are properly consulted, engaged, and informed.</li><li>Organize and facilitate participation from the dental analytics team. Ensure thorough documentation of findings and decisions.</li><li>Facilitate the design of the post-launch release management process for analytical tools and projects, including timing, requirement gathering, etc.</li><li>Provide analytical insights to influence business decisions and strategies within the dental organization.</li><li>Supervise and mentor one direct report, providing guidance and support for their professional development.</li></ul>Qualifications<ul><li>Bachelor's degree in Actuarial Science, Finance, Economics, or a related field strongly preferred.</li><li>5+ years of relevant experience in actuarial analysis or healthcare analytics. Prior dental or healthcare experience strongly preferred.</li><li>FSA designation preferred.</li><li>Strong analytical skills with the ability to dive into detailed methodological differences.</li><li>Excellent organizational skills with the ability to manage both detailed and big-picture items.</li><li>Great team player and effective communicator.</li><li>Proactive with the initiative and courage to recommend course corrections.</li><li>Experience in leading and mentoring team members.</li></ul>This role is anticipated to offer an annual salary of 126,900 - 211,500 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan.We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, and paid holidays.About Cigna HealthcareCigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Performs actuarial analyses for Medicare Advantage business, including medical expense analyses and projections, financial forecasts, Medicare Part C bid development, regulatory (CMS) filings, actuarial modeling/analysis, and ad hoc actuarial analyses/advice as needed. Communicate updates/results to management and associates.Responsibilities:<ul><li>Primary focus areas are Medicare pricing and CMS bid and supporting documentation development.</li><li>Support cross-market review of bids and develop/update supporting forecasting and analyses.</li><li>Applying analytical methods through the use of mathematical and statistical models in bid modeling and financial analyses.</li><li>Completing ad hoc assessments and projects for corporate-wide or market-specific initiatives.</li><li>Communicating results of analyses to more senior actuarial team members.</li><li>Actively participate in team and other internal meetings and may present on specific topics.</li></ul>Qualifications:<ul><li>Bachelor's Degree in Actuarial Science, Economics, Mathematics or other related field strongly preferred.</li><li>1-3+ years of actuarial or data analytics experience.</li><li>Actively progressing through Society of Actuaries exams strongly preferred.</li><li>Strong technical skills specifically in Excel.</li><li>Strong mathematical, financial, and statistical skills.</li><li>Must be detail-oriented and able to work independently with minimal supervision.</li><li>Strong communication and presentation skills; written/verbal proficiency.</li><li>Ability to identify problem areas and take initiative to implement solutions.</li><li>Healthcare / Medicare experience preferred.</li><li>Proficiency in SQL preferred.</li></ul>If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 70,200 - 117,000 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan.We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.About Cigna HealthcareCigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Performs actuarial analyses for Medicare Advantage business, including, but not limited to: medical expense analyses and projections, financial forecasts, Medicare Part C bid development, regulatory (CMS) filings, actuarial modeling/analysis, ad hoc actuarial analyses/advice as needed, and communicate updates/results to management and associates.Responsibilities:Primary focus areas are Medicare pricing and CMS bid and supporting documentation development, support cross-market review of bids, and develop/update supporting forecasting and analyses. Other responsibilities include:<ul><li>Applying analytical methods through the use of mathematical and statistical models in bid modeling and financial analyses.</li><li>Completing ad hoc assessments and projects for corporate-wide or market-specific initiatives.</li><li>Communicating results of analyses to more senior actuarial team members.</li><li>Actively participate in team and other internal meetings and may present on specific topics.</li><li>Ownership of the methodology and development of actuarial assumptions used in bid pricing.</li><li>Present results to a wide variety of matrix partners.</li></ul>Minimum Requirements:<ul><li>Bachelor's Degree in Actuarial Science, Economics, Mathematics or other related field strongly preferred.</li><li>3+ years of actuarial / data analytics experience.</li><li>Actively progressing through Society of Actuaries exams strongly preferred.</li><li>Strong technical skills specifically in Excel.</li><li>Strong mathematical, financial, and statistical skills.</li><li>Must be detail-oriented and able to work independently with minimal supervision.</li><li>Strong communication and presentation skills; written/verbal proficiency.</li><li>Ability to identify problem areas and take initiative to implement solutions.</li><li>Healthcare / Medicare bid experience strongly preferred.</li><li>Proficiency in SQL preferred.</li></ul>If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 84,900 - 141,500 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan.We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.About Cigna HealthcareCigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment.Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

The position requires an experienced actuarial viewpoint with a proven ability to work collaboratively with cross-functional teams and business partners. Performs actuarial analyses for Medicare Advantage business, including, but not limited to: medical expense analyses and projections, financial forecasts, Medicare Part C bid development, regulatory (CMS) bid submissions, actuarial modeling/analysis, and ad hoc actuarial analyses/advice as needed.Responsibilities:<ul><li>Primary focus areas are Medicare pricing and CMS bid and supporting documentation development.</li><li>Support cross-market review of bids and develop/update supporting forecasting and analyses.</li><li>Applying analytical methods through the use of mathematical and statistical models in bid modeling and financial analyses.</li><li>Completing ad hoc assessments and projects for corporate-wide or market-specific initiatives.</li><li>Communicating results of analyses to more senior actuarial team members.</li><li>Actively participate in team and other internal meetings and present on specific topics.</li><li>Provide guidance to stakeholders including product, finance, and other groups in the organization.</li><li>Balance multiple tasks and competing priorities while adhering to tight deadlines.</li><li>Ownership of the methodology and development of actuarial assumptions used in bid pricing and bid tools.</li><li>Manage 2-3+ team members.</li><li>Develop team including training on bid processes, technical, and soft skills.</li></ul>Requirements:<ul><li>Bachelor's Degree in Actuarial Science, Economics, Mathematics, or other related field strongly preferred.</li><li>5+ years of actuarial experience.</li><li>Associate of the Society of Actuaries (ASA) designation strongly preferred.</li><li>Strong mathematical, financial, statistical, and technical skills (Excel, SQL, etc.).</li><li>Strong communication and presentation skills; written/verbal proficiency.</li><li>Ability to identify problem areas and take initiative to implement solutions.</li><li>Must be detail-oriented and able to work independently with minimal supervision.</li><li>Extensive Medicare knowledge, with specific acumen in Part C strongly preferred.</li></ul>For this position, we anticipate offering an annual salary of 118,400 - 197,300 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan.We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, and paid holidays.About Cigna Healthcare:Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment.Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state, and local ordinances.

The position requires an experienced actuarial viewpoint with a proven ability to work collaboratively with cross-functional teams and business partners. Performs actuarial analyses for Medicare Advantage business, including, but not limited to: medical expense analyses and projections, financial forecasts, Medicare Part C bid development, regulatory (CMS) bid submissions, actuarial modeling/analysis, and ad hoc actuarial analyses/advice as needed.Responsibilities:<ul><li>Primary focus areas are Medicare pricing and CMS bid and supporting documentation development.</li><li>Support cross-market review of bids and develop/update supporting forecasting and analyses.</li><li>Applying analytical methods through the use of mathematical and statistical models in bid modeling and financial analyses.</li><li>Completing ad hoc assessments and projects for corporate-wide or market-specific initiatives.</li><li>Communicating results of analyses to more senior actuarial team members.</li><li>Actively participate in team and other internal meetings and present on specific topics.</li><li>Provide guidance to stakeholders from product, finance, and other groups in the organization.</li><li>Balance multiple tasks and competing priorities while adhering to tight deadlines.</li><li>Ownership of the methodology and development of actuarial assumptions used in bid pricing and bid tools.</li><li>Present results to a wide variety of matrix partners.</li><li>Manage up to 1 team member.</li></ul>Qualifications:<ul><li>Bachelor's Degree in Actuarial Science, Economics, Mathematics, or other related field strongly preferred.</li><li>4+ years of actuarial experience.</li><li>Associate of the Society of Actuaries (ASA) designation preferred.</li><li>Strong mathematical, financial, statistical, and technical skills (Excel, SQL, etc.).</li><li>Strong communication and presentation skills; written/verbal proficiency.</li><li>Ability to identify problem areas and take initiative to implement solutions.</li><li>Must be detail-oriented and able to work independently with minimal supervision.</li><li>Extensive Medicare knowledge, with specific acumen in Part C strongly preferred.</li></ul>This role is anticipated to offer an annual salary of 104,300 - 173,800 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan.We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company-paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, and paid holidays.About Cigna Healthcare:Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status, or any other characteristic protected by applicable equal employment opportunity laws.The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment.Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state, and local ordinances.

This position will provide external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space.The Actuarial Strategy role is designed to provide designated full-time support to Express-Script’s external client’s Medicare Part D business. This role will matrix with internal leadership within trend, formulary, clinical, knowledge solutions, sales & account management, and supply teams.The role will assist in the development of actuarial analyses for Medicare Part D business, including but not limited to special CMS programs, drug expense analyses and projections, financial forecasts, actuarial modeling, pharmacy network optimization strategies, manufacturer rebates optimization, regulatory impact assessment, and ad hoc actuarial analyses as needed.The position requires an experienced strategic viewpoint in a wide variety of actuarial prescription drug subjects within the enterprise, industry, and regulatory environments.The Essential Responsibilities of the Role include:Product Support / Development<ul><li>Co-lead development of Actuarial analytics products for Express Scripts existing Part D Plans.</li><li>Perform financial analyses of proposed regulatory changes, demonstration programs, and other special programs by CMS to determine financial impact on various entities within the drug supply chain.</li><li>Develop actuarial models to aid in prospective projections of Medicare Part D Plan client’s plan liability and premium impact sensitivities.</li><li>Build actuarial models and project management functions to accelerate and safeguard improvements in the development of analytics tools to identify gaps in the Medicare Part D market.</li><li>Lead studies to aid in identification of gaps in the Medicare Part D Prescription Drug Health market to aid in the development of strategies to help close identified gaps.</li></ul>Analytics Support to Part D Plans<ul><li>Drive strategic discussion to develop analytics road map to optimize Part-D revenue optimization and cost-reduction strategies for Medicare Part D Health Plans: PDP, MAPD, and Special Needs Program (SNPs).</li><li>Review Medicare Part D Plan bid assumptions for Regulated Medicare Part D Health Plans.</li><li>Create analytics for Medicare Part D Bids substantiation for Desk Review and Medicare Part D audits.</li><li>Utilize independent judgment and discretion to perform complex customized actuarial analyses for Part D Health Plans.</li></ul>Cross-Functional Financial Support<ul><li>Collaborate with internal Express-Scripts business partners and external vendors to determine operational feasibility and financial ramifications of special programs.</li><li>Apply distinct Part D subject matter expertise (SME) to facilitate analytics capabilities, measure performance, and aid in problem solving, and creation of actionable insights for technical teams within Express-Scripts enterprise.</li><li>Cross-functional collaboration within Express-Scripts enterprise Medicare Part D financial and operational strategy development. Examples include:</li><ul><li>Advanced trend analytics.</li><li>Medical Loss Ratio (MLR) / member profitability projections.</li><li>Formulary Strategy.</li><li>Clinical Analytics around prescription drugs pipeline products.</li><li>Out of Pocket Cost.</li><li>Member risk score analysis / benchmarking.</li><li>Quantification of impact of regulatory proposals and changes.</li><li>Regulated Part D Health Plan Financial Reconciliation Support.</li></ul><li>Assimilate macro and micro trends, develop benchmarks, gather competitive intelligence to develop market competitive strategies.</li><li>Train and educate non-actuarial internal teams on Medicare Part D market financial and analytics components.</li></ul>Qualifications<ul><li>Bachelor’s degree in Actuarial Science, Economics, Statistics, Finance or other quantitative field strongly preferred.</li><li>5+ years of actuarial experience or 3+ years of consulting experience.</li><li>ASA (or near ASA) strongly preferred; FSA preferred.</li><li>Part D Prescription Drug or Part D bid development consulting experience preferred.</li><li>Regulated Markets Medicare Part D Experience Pharmacy Benefit Manager (PBM) / Healthcare / pharmaceutical experience preferred; consulting experience strongly preferred.</li><li>Track record of managing multiple projects and teams that deliver client-driven growth, insightful actions.</li><li>Proven capabilities in modeling, forecasting, and predictive analytics.</li><li>Strong communication and presentation skills; written/verbal proficiency.</li><li>Strong leadership skills.</li><li>Coding skills in either SQL, R, SAS, or Python strongly preferred.</li><li>Preferred: Extensive understanding of US Prescription drug supply chain and Medicare knowledge, with specific acumen in Part D, including but not limited to:</li><ul><li>Part D Bid Development, Desk Review & Audits.</li><li>CMS Regulatory Compliance / Reporting.</li><li>Financial Reconciliation Modeling.</li><li>Trend Analyses.</li><li>Formulary Modeling Experience.</li><li>Network Optimization Modeling.</li><li>Rebates Modeling.</li><li>Market Landscape analytics.</li><li>Risk Score Modeling.</li></ul><li>Ability to gather and analyze information, execute a map and execute strategies designed to aid in growth of existing business and building of new businesses preferred.</li><li>Ability to structure ambiguous actuarial and financial analyses, and synthesize and communicate complex analyses in simple and digestible data-driven takeaways to internal and external senior leadership teams preferred.</li></ul>This role is anticipated to offer an annual salary of 109,400 - 182,300 USD / yearly, depending on relevant factors, including experience and geographic location.This role is also anticipated to be eligible to participate in an annual bonus plan.We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.About Evernorth Health ServicesEvernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Actuarial jobs at Cigna