Manager, Medical Economics

Bring your heart to CVS Health. Every 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 Behaviorsâ„¢ 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. Position Summary The Executive Analytics & Corporate Insights team in the Medical Economics Unit is seeking a medical economics professional with the primary role of evaluating internal and external medical cost trend and trend drivers across all four of Aetna's major lines of business (Commercial Group, Commercial Individual, Medicare Advantage, and Medicaid). This position will support a wide range of stakeholders, including Aetna/CVS Health Executive Leadership Teams, Finance, Actuarial, Network, Underwriting, Investor Relations, and Corporate Planning. 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. The work delivered in this role will support Aetna's medical cost management strategy, pricing position and earnings generation. The primary responsibility of this position is to innovate, design, maintain, and interpret the results of Aetna's date of service (DOS) reporting of medical cost trends across all four major lines of business (Commercial Group, Commercial Individual, Medicare Advantage, and Medicaid); this suite of reporting includes Executive Dashboards that are leveraged to communicate emerging financial results directly to Aetna's CFO and Chief Actuary This role will be support Aetna's medical cost forecasting process by developing recommendations for medical cost seasonality; working closely with Finance and Actuarial to ensure assumptions are incorporated properly into the forecasting process Proactively and independently identify critical medical cost issues and designs and recommends solutions to business problems to senior Executive leadership, and business partners Collaborates with other constituents on across Finance, Network, Underwriting, and Actuarial. Applies rigorous financial and value analysis to manage and enhance profitability and membership This analyst will consider the end-to-end user experience incorporating customer feedback to enhance the quality and usability of data, reporting, and tools 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 Apply technology to improve business processes and compliance (SQL, Python, SAS, VBA, R, and full suite of Microsoft Office products) and actively participate in the change management process related to emerging technologies and data, specifically the adoption of ADAM ( A etna D ate of Service A nalytic M odel) Cloud platform Primary Job Duties & Responsibilities: Perform complex medical and financial cost analysis to evaluate real time medical cost drivers and develop strategic options and opportunities to favorably impact medical cost across all four core lines of business Leverage strong communication skills and influence to lead development of new reporting and exhibits to provide deeper level of insight into drivers of medical cost trends to senior leadership Develops and presents actionable recommendations to management based on analysis. Collaborates with Medical Management on cost saving opportunities. Participates in research-related activities including industry best practices and experience studies. Performs other duties as required. Required Qualifications 5+ years relevant experience 3+ years experience in data analytics, business, finance, or other related role Preferred Qualifications Knowledge of key managed care functions including provider contracting, benefit design, medical management as well as knowledge of business functions and impact on financials (underwriting, sales, product development, network management) Expert analytical and problem-solving skills Strong organizational and time management and skills Excellent written and verbal communication and presentation skills Ability to develop new content to inform and influence senior business leads and relevant stakeholders Ability to manage conflicting priorities and multiple projects concurrently. Demonstrated initiative, innovation, and leadership in achieving results Excellent critical thinking skills and ability to express ideas clearly, concisely, and logically from a cross functional perspective Education Bachelor's Degree in economics, finance, business analytics, or related field Pay Range The typical pay range for this role is: $60,300.00 - $145,860.00 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ('PTO') or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits CVS Health (We anticipate the application window for this opening will close on: 10/28/2024 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.

Created: 2024-11-02