Manager - Medical Economics

CVS Health • Raleigh, NC • 21h 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

As a Manager, Medical Economics, you will be responsible for developing and maintaining complex financial reporting solutions that support Aetna's Medicaid Markets. This role will lead reporting for Value-Based Service contracts and contribute to other key reporting areas such as financial restatement, revenue reconciliation, enrollment reconciliation, member redetermination, and state-required cost reporting.

This position offers the opportunity to collaborate with actuarial and health plan finance teams to design, test, and enhance reporting processes. You will also identify opportunities for process improvement and ensure reporting accuracy and compliance with business requirements.

You will accomplish this by:

Developing and maintaining advanced queries using SQL Server Management Studio (SSMS) to produce accurate financial reports.

Partnering with internal teams to design and validate reporting solutions, providing technical support as needed.

Reviewing and improving existing processes to enhance efficiency and accuracy.

Testing and researching data to ensure completeness and compliance with business policies.

Your success will be determined by your ability to deliver accurate, timely reports, improve reporting processes, and collaborate effectively across teams. In this role, you will operate in a fast-paced, deadline-driven environment that requires strong technical and analytical skills.

Required Qualifications

5+ years of experience developing queries and reports using SQL Server Management Studio (SSMS).

3+ years of experience working with healthcare data.

Strong proficiency in Microsoft Excel, including pivot tables, formulas, and graphs.

Preferred Qualifications

Experience working with Medicaid and Medicare programs.

Advanced Excel skills (complex formulas, dynamic visualizations, VBA).

Experience with eligibility, claims adjudication, reserving, or financial reporting in the managed care industry.

Familiarity with Google Cloud Platform (GCP).

Background in health services research or epidemiology.

Education

Bachelor's degree in business, finance, public health, or a related field required.

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: 01/02/2026

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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