Actuary

• Owning the relationship with the National Health Systems organization
• Presenting analytics directly to national provider partners
• Leading the professional and technical development of one direct report
• Focus on emerging trend analytics, pricing and contracting support, and provider discount analyses

Lead Director – Network Actuarial, National Contracts

• Develop a quarterly, market-level discount review process to inform Regional Leads and Chief Network Officers of changes in benchmarking based on the latest view
• Identify gaps and pressured areas to consider for future negotiations
• Provide meaningful information to the field on the impact and expected timing of new negotiations beyond current consultant benchmarking
• Engage cross-functionally with Network, MEU, and other teams to drive enhanced contract negotiation strategies using data-driven recommendations for MedRx and Behavioral Health
• Provide support for Aetna Whole Health / APCN Plus (Performance Networks), joint ventures, and narrow network pricing across all Commercial market segments
• Validate and refine pricing using contracting insights such as trend, PCRs, and area factors during Large Group Rate Review
• Build a suite of tools and analyses to provide optimal strategic support for Priority Markets and Strategic/Enhanced Providers
• Address a complex and error-prone mix of state-specific standard contracts by selecting a single, competitive fee schedule that is consistent across state lines.

Senior Actuary – Network

• Work in a fast-paced, innovative, and change-oriented work environment
• Build a strong network of peers and mentors
• Attend on-site technical and professional development classes
• Participate in sponsored community service events
• Utilize advanced Excel techniques and programming
• Work with large data sets
• Gain exposure to actuarial software, including GGY AXIS, MG-ALFA, and PolySystems

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Lead Director – Network Actuarial, National Contracts

Senior Actuary – Network

Associate Actuarial Development Program – Actuary