Aetna is recruiting for an Executive Director, Actuarial who will be responsible for understanding and driving action on Medicare Network Insights and curating support for this important line of business. This is an entirely Medicare focused role surrounding delivering on our overarching Medicare network strategy; it is inclusive of target network development in new geographies, and development of networks to support unique Medicare member needs.You will make an impact by:- Achieving profitability and membership goals with business partners by contributing to strategies and executing them.
- Enabling Network Market leaders to drive Network Performance analysis at a market level- data cubes, HCIC (health care information center), curation of a network, and overall provider performance.
- Participating in state specific RFP conversations.
- Identifying core issues and leveraging colleagues/network to solve them.
- Navigating several data points, possibly contradictory, and rationalizes recommended course of action, recognizing risks and opportunities. Works with different areas to understand those data points. Recommends logical actions based on data and business acumen that weighs the pros and cons of calculated risks.
- Forming own opinions based in logic and business sense and having the flexibility to adjust as new ideas are presented, ie. shows a great balance of confidence, open-mindedness, and modesty.
- Ability for divergent thinking for brainstorming and connecting many ideas and ability for convergent thinking to ensure a recommended course of action and execution. When ideas do not work, have the perseverance to move forward and inspire their team to adjust.
- Building and facilitating a team environment of trust to foster collaboration and teamwork. Develops and empowers sharing ideas across the organization.
- Influencing resources within and outside of direct control to complete projects.
Location: Hybrid or RemoteQualifications
The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company's business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes:- 10+ years actuarial health insurance experience.
- Experience with Medicare Bid Pricing, Fee Schedule (IPPS/OPPS/Physician), and over all CMS knowledge
- IRA knowledge would be valued
- Approximately 5+ years of people management experience.
- Broad experience with all actuarial functions.
- Adept at execution and delivery (planning, delivering, and supporting) skills.
- Experience working in a highly matrixed environment.
- Advanced Excel application design skills, with ability to pull/manipulate data using SQL
- Ability to conceptualize new product services and new financial models.
- Possess an Executive Presence to present to internal and external customers.
- Mastery of growth mindset (agility and developing yourself and others) skills.
EducationBachelor's degree or equivalent.ASA requiredFSA valuedPay RangeThe typical pay range for this role is:
$175,100.00 - $334,750.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 05/22/2026
