Manager, Medical Economics

CVS Health • Augusta, ME • 12h 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.

Position Summary

The Capitation Center of Excellence (COE) team provides oversight for monthly capitation payment submission and processing, ensuring leadership receives information needed for monthly general ledger locks. Individual will need to collaborate with network, accounting, finance, products/benefit area and other internal business areas. Must be able to isolate and troubleshoot issues post capitation run and share findings across teams and the cap system vendor. Issues such as drivers of change and root cause. Must be comfortable working in high paced environment as capitation payments issued and reporting must keep to a monthly cycle. Individual will be present in meetings with programmers that support the capitation system during troubleshooting discussions. Individual must be able to multi-task and work with urgency during monthly cap runs. Must be able to work with large amounts of data as position requires pulling data and summarizing results using Coginity. Individual will be required to present issues and finding to internal team and at times external providers. Must be able to demonstrate critical thinking ability and see issues, tasks to completion. Individual must be able to work in Excel using pivots, formulas, and lookups.

Required Qualifications

3+ years' experience directly related to the duties and responsibilities specified, or an equivalent combination of education and work experience.

Very strong interpersonal, relationship management, writing and presentation skills, Proven project leadership experience, critical thinking and data analysis.

Must have knowledge and strong user of Excel and comfort with MS Office applications.

Preferred Qualifications

Strong knowledge of EPDB, SCM, Capitation, ACAS, preferred.

Knowledge of SQL, Excel and comfort with MS Office applications.

Education

Bachelor's degree or equivalent experience

This remote role does not provide sponsorship at this time.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,300.00 - $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: 08/25/2025

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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