Senior Manager, Medical Economics

Job not on LinkedIn

🔥 13 hours ago

🦌 Connecticut, Florida, +10 more states – Remote

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💵 $82.9k - $182.5k / year

⏰ Full Time

🟠 Senior

👔 Manager

👻 Ghost score 0%

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Logo of CVS Health

CVS Health

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Analyze medical costs, quality outcomes, and utilization drivers to support value-based primary care • Plan, conduct, and lead healthcare claims-data analyses to identify trends, anomalies, and root causes • Translate complex datasets into actionable strategies for executive and field leadership • Develop financial models and forecasts related to healthcare costs and utilization • Project future healthcare expenditures and estimate potential savings • Evaluate the financial impact of clinical initiatives and interventions • Design and maintain reports and dashboards tracking performance metrics and economic drivers • Collaborate with Finance, Clinical, and Data Science teams to identify cost-saving opportunities • Optimize value-based payment models • Evaluate value-based care initiatives’ effects on medical costs and quality outcomes, including clinical and financial ROI • Partner with Data Engineering to develop long-term data assets and scalable analytics infrastructure • Ensure analyses and reporting comply with regulatory requirements and industry standards

🎯 Requirements

• 7 years of experience in quantitative analysis, healthcare analytics, or medical economics within the healthcare or payer industry • Deep subject matter expertise in value-based care, population health, and medical claims data (ICD-10, CPT) • Advanced proficiency in SQL for complex data extraction, manipulation, and analysis • Proven track record of leading cross-functional teams and presenting executive-ready insights to C-suite and clinical leadership • Exceptional problem-solving, decision-making, and project execution skills • Proficiency with business intelligence tools such as Tableau or Power BI preferred • Experience in value-based care analytics for Medicare Advantage and Traditional Medicare programs preferred • Bachelor’s degree in a STEM field, finance, economics, or a related analytical discipline

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • Equity award program • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being

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