Sr Analyst, Medical Economics

CVS Health

5d

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 Performs complex medical economic projects (e.g. contract rate modeling) Accountabilities include identification and completion of key deliverables to ensure all business objectives are met. Responsible for the development and implementation of key medical economics business efforts e.g.medical cost initiatives, policies/programs, budget and analytical models. Partners and consults with Network Management to provide medical cost analysis to assess effectiveness of contracted rates, creating and implementing plans to effectively manage medical costs based on analysis or trends. Develops market specific provider reimbursement schedules Oversees the production of both standard and ad-hoc reports used for risk assessment analysis, budgeting, and hospital chargemaster analysis and forecasting. Coordinates rate approvals and develops pricing for most complex contractual arrangements. Develops and communicates tactical and strategic plans to satisfy information needs across products, segments and markets to a broad audience

Requirements

• 3+ years demonstrated leadership and/or project management experience
• 3+ years of healthcare and/or analysis experience.
• Bachelor's Degree or equivalent work experience required

Nice To Haves

• Knowledge of managed care and how provider reimbursement policies relate to the control of medical claims costs.
• Comprehension of provider contracts and the potential impact the regulatory/legislative environment has on reimbursement strategies.
• Understanding of internal and external database applications.
• Knowledge of market-place delivery (understanding of provider relationships).
• Skill in:
• Strong communication/presentation skills.
• Strong software and modeling skills.
• Strong analytical ability and familiarity with advanced financial and healthcare concepts.
• Ability to manage conflicting priorities and multiple projects concurrently.

Responsibilities

• Performs complex medical economic projects (e.g. contract rate modeling)
• Accountabilities include identification and completion of key deliverables to ensure all business objectives are met.
• Responsible for the development and implementation of key medical economics business efforts e.g.medical cost initiatives, policies/programs, budget and analytical models.
• Partners and consults with Network Management to provide medical cost analysis to assess effectiveness of contracted rates, creating and implementing plans to effectively manage medical costs based on analysis or trends.
• Develops market specific provider reimbursement schedules
• Oversees the production of both standard and ad-hoc reports used for risk assessment analysis, budgeting, and hospital chargemaster analysis and forecasting.
• Coordinates rate approvals and develops pricing for most complex contractual arrangements.
• Develops and communicates tactical and strategic plans to satisfy information needs across products, segments and markets to a broad audience

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: Mid Level
• Number of Employees: 5,001-10,000 employees