Job Description

This position oversees the end-to-end coordination and submission of compliant Part D bids to the Centers for Medicare & Medicaid Services (CMS) for all markets/regions in which Cigna participates, financial projections for all Prescription Drug Plan (PDP) products, and actuarial strategic analyses for all Part D products. Utilizing independent judgment and discretion, this position initiates, organizes, directs and analyzes actuarial research and oversees the development of actuarial assumptions, pricing strategies and actuarial policies. This position sits within the Medicare Advantage and Part D Actuarial team and serves as a key strategic partner to Product, Bid Strategy, Clinical/Formulary, and Medicare Advantage Actuarial, working to achieve profitability and growth goals. This position will manage a team of three actuaries and/or actuarial students; has advanced knowledge of actuarial statistics/assumptions used for ratemaking; is familiar with internal and external statistical methods and sources of data, and the use of spreadsheet applications; and has a deep understanding of CMS regulations and requirements.

Responsibilities:

• Oversee the end-to-end coordination and submission of compliant Part D bids to CMS for all markets/regions in which Cigna participates
• Collaborate with internal Part D matrix colleagues to develop business and pricing strategy, providing thought leadership on product development, pricing/bids, formulary analysis, regulatory change impact analysis, forecasting, and risk management
• Oversee an extended team of 3 actuaries and actuarial students that manages rate filings and signs actuarial opinions / supporting documents to be reviewed by state and federal regulators
• Mentor staff to improve skillset and career opportunities
• Support talent strategy that develops, recruits, and retains actuarial talent.
• Manage the function through CMS desk review and other audit activity (e.g., OACT audits)
• Support other ad hoc Part D pricing / strategic work as needed
• Utilizes independent judgment and discretion, performs financial projections and actuarial analysis for complex assignments including:

+ Trend Analysis (Internal & Industry comparisons)
+ Network analysis, management, and governance
+ Formulary modeling
+ Impact of Regulatory Changes
+ Bid pricing support
+ Participate in internal strategic discussions to help develop strategic plan for bids

• Assists in the analysis of Part D bid strategy proposals including:

+ Extensive experience and understanding of Part-D bid mechanics and regulations
+ Strategic thought process to optimize Part-D pricing for PDP products
+ Ability to assimilate macro- and micro-trends to develop market competitive products or strategies
+ Cross-functional collaboration on strategy development is critical for the success of the role
+ Help identify competitive information, develop benchmarks and pull together competitive intelligence for internal discussion and insight

• Assists in the analysis of Part D special projects including:

+ Performing financial analysis of demonstration programs and other special programs by CMS to determine financial impact
+ Works with business partners to determine operational feasibility of special programs
+ Develops strategy recommendations for special programs

Qualifications:

• Bachelors degree in Finance, Actuarial Science or related field
• 10+ years of professional actuarial work experience
• Proven capabilities in modeling, forecasting, and predictive analytics
• Direct experience with Part D and a deep understanding of bid process and requirements strongly preferred
• Attained FSA designation preferred
• Outstanding actuarial technical abilities, problem-solving, analytical and critical thinking skills, and creativity
• Excellent verbal, written communication and presentation skills, as well as strong interpersonal skills
• Demonstrated thought leadership on challenging problems with examples of implementing innovative solutions, actions taken, and driving outstanding results.
• Strong competencies around dealing with ambiguity, perseverance, organizational agility, external stakeholder negotiations, and drive for results
• Have the ability to work independently and in conjunction with coworkers and matrix partners of all levels.
• Ability to expertly utilize SQL and/or SAS for data mining preferred
• Integration of competitive intelligence for predictive modeling purposes preferred
• Preference: Extensive Medicare knowledge, with specific acumen in Part D, including:

+ Bid preparation and desk review
+ CMS compliance
+ CMS audit requirements

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 142,700 - 237,800 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus and long term incentive plan.

We want you to be healthy, balanced, and feel secure. That\'s why you\'ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you\'ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

eQuest