Manager VBC Analytics Medicaid

CVS Health • Irving, TX

1d

About The Position

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 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

• 5+ years of prior healthcare analytics work experience
• Proficiency in excel
• Experience in translating complex data into actionable information and communicate effectively to varied audiences
• Strong written and verbal communication skills

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.
• 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