Manager, Medical Economics

CVS Health • Blue Bell, PA • 4w ago

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Requisition Job Description

As a member of the Value Based Analytics team, you would be responsible for supporting complex capitation analyses that support our strategic goals for Medicaid, Medicare and IFP, and working collaboratively with the Network to determine the financial impact resulting from changes in provider contracts and payment methodologies.

Conducts in-depth analysis of healthcare economic data to identify cost drivers, trends, and patterns to progress cost management strategies.

Develops financial models and forecasts related to healthcare costs and utilization, for senior management review and presentation.

Projects future costs, estimates savings opportunities and evaluates the financial impact of different reimbursement methodologies, initiatives and interventions.

Collaborates with cross-functional teams to identify cost-saving opportunities, evaluate alternative payment models, optimize network and provider contracts, and implement core economic strategies.

Assists with workflow development and strategies to integrate data and reporting

Works independently to manage relationships and identify/implement solutions to problems

Leverages reporting/data to monitor contract performance against financial targets

Identifies areas where improvements need to be made

Required Qualifications

This position is part of a team that provides focused analytical research, complex financial modeling and business decision support related to medical cost. Since data mining and "what-if" scenarios are the regular analytical approach, this position is a perfect fit for somebody who is thinking outside of the box and who is able to turn data into useful information. The candidate will be expected to have the following key attributes:

3+ years of experience with model development

Adept at execution and delivery (planning, delivering, and supporting) skills

Ability to pull data using SAS, SQL or Google Cloud

Adept at business intelligence

Adept at collaboration and teamwork.

Problem solving and decision-making skills

Growth mindset (agility and developing yourself and others) skills

Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias

Preferred Qualifications

Experience in capitation analytics

Experience in Medicaid or Medicare

Experience in Risk-Based Arrangements and Value-Based Care financial models

Education

Bachelor's degree in Math, Actuarial Science, Economics or another related degree preferred/specialized training/relevant professional qualification.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,300.00 - $145,860.00

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 05/30/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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