Anticipated End Date:
2026-07-30
Position Title:
Associate Actuary (Medicare Pharmacy Trend Analytics) - CarelonRx
Job Description:
Associate Actuary (Medicare Pharmacy Trend Analytics) - CarelonRx
Hybrid: This role requires associates to be in-office1-2days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unlessaccommodationis granted as required by law.
The Associate Actuary (Medicare Pharmacy Trend Analytics) - CarelonRx completes the most diverse and complex projects and performs highly complex actuarial studies to evaluate and explain Medicare Part B and Part D pharmacy financial performance.
This role serves as the subject matter expert for Medicare pharmacy spend and trend performance, providing insights that directly influence pricing strategy, product design, financial forecasting, and executive decision-making.
How you will make an impact:
- Prepares and presents Medicare Part D and Part B drug spend and trend analyses for Medicare Individual and Group (GRS) businesses, communicating key cost drivers, product mix, member demographics, population shifts, and seasonality to support business decisions.
- Delivers actionable pharmacy spend and trend insights through recurring trend reporting, cohort studies, benefit phase analyses, and ad hoc analyses to identify emerging trends and assess Medicare pharmacy financial performance.
- Performs key actuarial functions including new product pricing, evaluation of the impact of new legislation, flexible benefit consulting, and special projects.
- Designs and completes special projects such as developing and maintaining experience-rating formulae and creating and/or reviewing alternative settlement formulae and risk-sharing models.
- Responsible for recommendations on pricing, marketing, product design, claims, premium, and enrollment administration of the business unit.
- Responsible for valuation support for the business unit by interpreting financial results and variances from forecast to identify product and segment behavior and assist in the risk management of the business unit.
Minimum Requirements:
- Requires a BA/BS degree and a minimum of 4 years of related experience; or any combination of education and experience that would provide an equivalent background.
- Associate of the Society of Actuaries (ASA) designation required.
Preferred Skills, Capabilities and Experiences:
- Previous Pharmacy Benefit Management (PBM) experience strongly preferred.
- Medicare Part D experience strongly preferred.
- Experience analyzing Medicare Part B drug spend and trend.
- Strong presentation and communication skills with the ability to explain complex Medicare Part B and Part D pharmacy spend and trend drivers to executive and health plan leadership.
- Experience interpreting pharmacy financial performance and communicating actionable insights to business stakeholders.
- Experience performing pharmacy spend and trend analyses, cohort studies, benefit phase analyses, and retrospective trend reporting.
- Experience evaluating the financial impact of CMS programs and Medicare legislation, including the Inflation Reduction Act (IRA).
- Experience with Databricks, SQL, Python, Snowflake, and Power BI.
- Experience working with large healthcare claims datasets and developing analytical reporting and visualization solutions.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $126,720 to $190,080.
Locations: Mendota Heights, Minnesota
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
*The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, paid time off, stock, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
Job Level:
Non-Management Exempt
Workshift:
Job Family:
ACT > Actuarial
