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Aetna is now a CVS Health Company

Sr. Director, Medicaid Actuarial Strategy

Primary Location: Phoenix, AZ
Additional Locations: AZ-Phoenix, MD-Baltimore
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Description:
Manage a multi-functional and multi-tiered group of actuarial staff in support of department mission to protect Aetna’s financial integrity. Sponsor projects in support of strategic and cross-enterprise operating plan and business development goals. Negotiate and influence sound corporate decisions by adhering to established risk management principles. Anticipate and recognize matters that materially affect financial results and make sound, unbiased reports on these matters. Functionally includes business unit actuaries, Medicaid business unit Finance and Business Development, and Corporate valuation and medical economics actuaries with responsibilities that may cross markets, programs or business units.

Position will be responsible for coordination and interaction across entire Medicaid business unit as well as require developing expertise in Medicaid/Medicare crossover opportunities. Medicaid Actuarial Strategy will also be involved in developing standard analyses and models, model improvements and enhancements, and training of new and junior members of the team when necessary.

Fundamental Components:
Leadership: Management of Resources- Sponsor, develop and lead projects to support strategic and operating plans.
Influence/motivate resources within and outside of direct control to complete projects. Exhibit innovative use of resources.
Scope of Decision Making- Broad decision making authority that may cross multiple disciplines, functions, regions or segments.
Staffing/Personnel- Influence the development of a high performing team through more strategic oriented human capital planning. Ensure access to appropriate tools, resources and training.
Aetna Way- Foster behavior that reflects Aetna’s values and is in accordance with the Aetna Way.
Product & Business Knowledge: Assumptions & Data Sources- Review analyses developed by staff from a business perspective and be able to influence senior management to accept alternative recommendations. Integrate understanding of internal and external data sources for quantifying risks.
Programs, Policies & Processes- Apply knowledge of corporate products, programs, processes and policies to resolve cross-functional and cross-enterprise problems and issues.
Regulatory Issues- Assure compliance with applicable regulations, laws and standards.
Risk Analysis & Management: Risk Assessment- Provide leadership in the negotiation and influencing of sound business decisions through adherence to established risk management principles.
Reserve Analysis- Review reserve recommendations and set adequate reserve levels.
Planning & Forecasting- Review recommendations and set forecast in collaboration with finance and business partners.
Pricing, Trend & Benefit Design- Partner with business owners in decision making process around pricing and trend.
Technical Proficiency: Use of Technology- Develop creative technical solutions to a variety of problems. Stay apprised of technical innovations as potential solutions for actuarial issues and concerns.
Development & Implementation- Oversee/manage the development and implementation of tools and models.
Testing- Review testing results for changes to processes, tools and systems.
Verbal & Written Communication- Address most complex business issues. Have direct interaction with internal and external constituents. Maintain accurate documentation and consult on training and user support for tools and processes.
Interaction with Constituents- Promote and influence collaboration.

Background Experience:
Bachelor's degree along with 10+ years experience.
Must be an ASA or FSA and a member of the American Academy of Actuaries.
Experience with Medicare a plus; experience with Medicaid desired but not required.
Prior management experience is required.
Healthcare background is also required.

Potential Telework Position:
Yes

Percent of Travel Required:
10 - 25%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Click To Review Our Benefits (PDF)

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