About the role
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position Summary
We are seeking a remote analytical professional to join our Medical Economics - Medical Expense Review (MER) team. The primary goals of this team are to a) identify and communicate with leadership specific provider, procedure and population level trends and outliers impacting the health plans medical cost trends, and b) analyze and size potential savings initiatives in coordination with clinical, finance, and network leads.
Required Qualifications
- 5+ years financial experience.
- 3-5 years’ experience with key managed care functions including provider and population analytics, provider contracting, benefit design, medical management as well as knowledge of business functions and impact on financials.
- Advanced skills in Excel, and Web-based query tools to pull and analyze ad-hoc data.
- Critical skills within Excel include use of pivot tables to sort and organize data, use of formulas for financial modeling and data tagging, and creation of data visualizations to effectively communicate the trend story
- Essential skill as reporting “super user” – able to easily navigate, comprehend, and tease out findings with a variety of enterprise reporting tools.
- 1+ years expereince presenting to executive audience
- Proven ability with critical thinking and expressing ideas clearly, concisely and logically from a cross functional perspective.
- Proven ability managing conflicting priorities and multiple projects concurrently. Demonstrates initiative, innovation and leadership in achieving results.
- Ability to learn new technologies and analytic approaches.
Preferred Qualifications
- Expereince with Medicaid.
- SQL Coding: including the ability to run ad-hoc analyses to answer specific clinical or financial questions for the Account, Finance, UM, or Network Teams.
- 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.
- An understanding of the healthcare industry.
- Underwriting, sales, product development, network management.
Education
- Bachelor’s Degree in business, finance, or related field OR equivalent experience.
**This Remote role does not support visas**
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$60,300.00 - $145,860.00This 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Aplyr's read
CVS Health is a healthcare giant blending retail pharmacy with insurance services, ideal for those interested in diverse healthcare roles and innovation.
What's promising
- •CVS Health's integration of pharmacy and insurance offers diverse career paths.
- •Strong focus on healthcare innovation with initiatives like HealthHUB locations.
- •Extensive national presence provides job stability and opportunities for relocation.
What to watch
- •Recent layoffs in certain divisions raise concerns about job security.
- •High-pressure retail environment may lead to employee burnout.
- •Complex organizational structure can slow decision-making processes.
Why CVS Health
- •CVS Health's acquisition of Aetna uniquely positions it in both retail and insurance sectors.
- •HealthHUB stores offer a distinctive model combining retail and healthcare services.
- •CVS Caremark provides a robust platform for pharmacy benefits management.
Aplyr’s read is generated by AI from public sources. Was it useful?
About CVS Health
CVS Health is a healthcare company that provides a range of services including pharmacy benefits management, retail pharmacy, and health insurance services.
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