Manager, VBC Analytics, Medicaid

CVS Health

12d

About The Position

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 Aetna is recruiting for a Manger on the Medicaid VBC Analytics team to support VBC partnerships throughout Aetna’s Medicaid segment to deliver on Aetna’s Medicaid VBC strategy. As an individual contributor, you will partner collaboratively and cross functionally with Network, health plan and VBC strategy customers as well as multiple business areas and other team members to promote the development, growth and operationalization of effective value based contracts across Aetna’s Medicaid plans.

Requirements

• Seeking a detail-oriented individual with superior analytical and problem-solving skills.
• Strong organizational skills, attention to detail, ability to work independently based on strategic direction, and ability to drive resolution across internal and external stakeholders.
• Ability to react quickly, change focus when needed, and handle multiple priorities in a fast-paced environment.
• Strong written and verbal communication skills.
• Must be able to translate complex data into actionable information and communicate effectively to varied audiences including health plan senior leadership and a multitude of internal business partners.
• Desire to be a member of dynamic team of individuals who work closely together in support of common goals.
• Advanced Excel skills required.
• 5-7 years of prior relevant work experience required.

Nice To Haves

• Experience querying and working with large data sets such as claims data.
• Prior experience handling financial data – claim, revenue, restatement, etc.
• Prior experience in Medicaid managed care and/or value based care, or medical underwriting.
• Knowledge of managed care, provider contracts and provider reimbursement methodologies.
• Understanding of managed care and how provider reimbursement policies relate to the control of medical claims costs.

Responsibilities

• Querying and analysis of complex provider claim, financial and other data to support VBC negotiations/renegotiation and ideation of new VBC arrangements.
• Creation of reports, models and analysis including financial performance.
• Support the administration of established VBCs including setup, financial reconciliation, payment support, and problem-solving.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees