Manager, Medical Economics

CVS Health • Trenton, NJ • 19h 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

Are you a data-driven problem solver with a passion for healthcare economics? Join our team as a Manager, Medical Economics and play a pivotal role in shaping cost-effective healthcare strategies. You'll work both independently and collaboratively on high-impact projects-like contract rate modeling-that directly influence business decisions and improve patient outcomes.

What You'll Do

Lead complex medical economic initiatives from concept to completion, ensuring alignment with strategic goals.

Drive innovation in cost management through the development of analytical models, policies, and programs.

Partner with Network Management to analyze contracted rates and identify actionable insights that optimize provider reimbursement and control medical costs.

Design market-specific provider reimbursement schedules that reflect local dynamics and strategic priorities.

Deliver high-value reporting -both standard and ad-hoc-for risk assessment, budgeting, and forecasting, including hospital chargemaster analysis.

Coordinate rate approvals and pricing strategies for the most complex contractual arrangements.

Communicate strategic insights across products, segments, and markets to diverse stakeholders, turning data into decisions.

Required Qualifications

5+ years demonstrated leadership and/or project management experience

5+ years of healthcare and/or analysis experience.

Preferred Qualifications

Extensive knowledge of managed care and how provider reimbursement policies relate to the control of medical claims costs.

Full comprehension of provider contracts and the potential impact the regulatory/legislative environment has on reimbursement strategies.

Understanding of internal and external database applications.

Knowledge of market-place delivery (understanding of provider relationships).

Skill in:

Advanced communication/presentation skills.

Advanced software and modeling skills, e.g. Microsoft Excel and Access, SAS.

Strong analytical ability and familiarity with advanced financial and healthcare concepts.

Ability to manage conflicting priorities and multiple projects concurrently.

Education

Bachelor's Degree or equivalent work experience required

This is a remote role located in the East or Central USA and is not available for sponsorship at this time.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,300.00 - $159,120.00

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: 09/29/2025

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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