Medical Economics Manager
CVS Pharmacy - Hartford, CT
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Job DescriptionThe National Medical Cost Analytics team in the Medical Economics Unit is seeking an analytical professional with the primary role of supporting the Aetna HCB Medicaid MENTOR process. This is an exciting opportunity to leverage medical cost analytics skills and business acumen to serve as a liaison to the business leads and stakeholders in actuarial, product, network, finance, etc. to provide actionable insight in response to medical cost drivers. The candidate will work in a fast-paced, dynamic, and rapidly changing environment and gain exposure to many different areas of the company through collaboration and communication of results in the form of standard quarterly reporting and ad hoc requests. This is an analytical position in a very fast paced and dynamic environment with a high performing team and high expectations. This high-performing analyst is responsible for evaluating internal and external medical cost trend and trend drivers and works collaboratively across Finance, Actuarial, and Data Science to determine the financial impact resulting from changes CVS Health and Aetna's medical cost management strategy, pricing position and earnings generation. This position will combine focused analytical research, complex financial modeling, and business decision support related to medical cost actions and medical cost strategy with decision making on pricing and long term, sustainable earnings growth. This analyst is required to interface with senior leadership, describing detailed and intricate data in a way that can be digested by VPs and above. The role combines a dense subject matter expertise with proficient communication skills. This analyst will advocate for the effective use of technologies and provides appropriate development to build colleague competence both within and external to MEU A successful analyst applies technology to improve business processes and compliance (SQL, Python, SAS, VBA, R, and full suite of Microsoft Office products) This analyst will actively participate in the change management process related to emerging technologies and data, specifically the successful launch and adoption of new ADAM (Aetna Date of Service Analytic Model) Cloud platform A highly successful analyst will demonstrate the capability to identify and analyze drivers of internal and external medical cost trends and propose scenarios upon which a variety of cost saving actions can be taken This role will support enterprise strategy by providing Health Care Benefits executives with the medical cost trend information needed to make informed decisionsRequired Qualifications5 or more years' experience in the managed care industry doing contracting, reimbursement, product and benefits design.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications Knowledge of Medicaid line of business, products, and governing state and federal legislation Skills in leading change, developing new content to inform and influence business leads and relevant stakeholders Ability to leverage business acumen to anticipate stakeholders needs to shape content and communication Excellent analytical and problem-solving skills Strong organizational, management and leadership skills Excellent written and verbal communication and presentation skills.EducationBachelor's Degree or equivalent work experience required.Business OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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.
Created: 2024-09-07