Pricing Analyst Senior - Remote
Prime Therapeutics
PythonSQL
Actuary – Medicare Part D
The Cigna Group
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $109,400 - $182,300 per year
Job Level
Mid-LevelSenior
Tech Stack
PythonSQL
About the role
- Provide external actuarial analytics support within the regulated Medicare market and PBM Healthplan space for Express Scripts’ Medicare Part D business
- Co-lead development of Actuarial analytics products for Express Scripts existing Part D Plans
- Perform financial analyses of proposed regulatory changes, CMS demonstration programs, and other CMS programs to determine financial impact
- Develop actuarial models for prospective projections of Plan liability and premium impact sensitivities
- Build models and project management functions to accelerate analytics tool development and identify gaps in Part D market
- Lead studies to identify gaps in Part D Prescription Drug Health market to inform strategies
- Drive analytics road map to optimize Part-D revenue and cost-reduction strategies for PDPs, MAPD, SNPs
- Review Part D bid assumptions for Regulated Part D Health Plans; create analytics for bid substantiation for desk review and audits
- Utilize independent judgement to perform complex customized actuarial analyses for Part D Health Plans
- Collaborate with internal and external partners to determine feasibility and financial implications of special programs
- Apply Part D SME to facilitate analytics and insights for technical teams
- Assist in Medicare Part D financial and operational strategy development
- Train and educate non-actuarial teams on Part D market financial and analytics components
Requirements
- Bachelor's degree in Actuarial Science, Economics, Statistics, Finance or other quantitative field strongly preferred
- 5+ years of actuarial experience or 3+ years of consulting experience
- ASA (or near ASA) strongly preferred; FSA preferred
- Part D Prescription Drug or Part D bid development consulting experience preferred
- Regulated Markets Medicare Part D Experience
- Pharmacy Benefit Manager (PBM) / Healthcare / pharmaceutical experience preferred; consulting experience strongly preferred
- Track record of managing multiple projects and teams that deliver client driven growth, insightful actions
- Proven capabilities in modeling, forecasting, and predictive analytics
- Strong communication and presentation skills; written/ verbal proficiency
- Coding skills in either SQL, R, SAS, or Python strongly preferred
- Extensive understanding of US Prescription drug supply chain and Medicare knowledge, with specific acumen in Part D, including but not limited to: Part D Bid Development, Desk Review & Audits
- CMS Regulatory Compliance / Reporting
- Financial Reconciliation Modeling
- Trend Analyses Formulary Modeling
- Network Optimization Modeling
- Rebates Modeling
- Market Landscape analytics
- Risk Score Modeling
- 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
- 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
