Strategic Analytics Manager

CVS Health•Work At Home-Illinois, IL

2d•$54,300 - $145,860•Remote

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 We are expanding the Medicare strategy and insights team to support provider enablement activities. This position will serve as subject matter expert on Medicare Risk Adjustment at-risk provider reporting and will be responsible for tracking and analyzing risk adjustment activities and performance at provider group and Group sponsor level. They will collaborate closely with Revenue Integrity Provider Optimization and Excellence (RIPOE) to create best-in-class at-risk provider enablement initiatives.

Requirements

5+ years’ experience of design and coding efficiency in SAS, SQL, Python or similar programming language.
5+ years’ experience leading the development of analytic solutions and initiatives with track record of business impact.
Data analytics or business intelligence
The dynamics of supporting a variety of stakeholders that serve the business
Business integrity and accountability
Working experience with member, claim, encounter, pharmacy, or diagnosis data
Experience working with large sets of data and solving data challenges
Effective reporting and communication
Strong customer service skills
Be a self starter, staying curious and self solve for issues with little direction being mindful of strict deadlines
Be comfortable with change
Execute algorithms to solve business problems
Interact with a variety of stakeholders
Be very organized; attention to detail
Motivated and willing to probe into technical details
Learn and absorb quickly varying state rules and regulations
Juggle multiple priorities successfully and pivoting to new solutions or processes if needed

Nice To Haves

Government-regulated healthcare programs such as Commercial, Medicare or Medicaid
Health insurance concepts and definitions
Risk Adjustment (Commercial, Medicare or Medicaid)
Population health analytics
Prior experience working for a health plan
Demonstrated experience in building business intelligence solutions and dashboards in Tableau, AWS or Python programming language.
Risk score calculations
Statistical modeling
Reporting and visualization
Build automated end-to-end processes

Responsibilities

Develop and Maintain analytical tools to support RIPOE activities.
Design and develop analytical solutions leveraging GCP, AWS, Databricks, SAS, SQL, and related cloud technologies to support Medicare Informatics initiatives.
Create scalable data assets and reporting frameworks utilizing modern cloud-based data platforms and data engineering best practices.
Develop analytical tools including membership trend, Risk score trend, chronic conditions and clinical tracking metrices.
Provide ad-hoc analytic solutions to help business partners understand their problems and goals.
Assist in creation of new health metrics and implementation.
Build Provider Group (PBG/PBP/MSO) specific reporting for Engagement Managers
Develop and publish internal/external reporting and communication with stakeholders for action plans
Act as an analytics expert to translate business needs into strategic projects and actions.
Develop and maintain MEU and Financial data assets, BI tools, and cloud-based analytical solutions using Databricks, GCP, AWS, and SAS to support at-risk provider reporting, reconciliation of RAPS/EDS, Medical Cost Funds, and overall performance management.
Apply business rules to identify improvement opportunities in clinical coding and member engagement.
Serve as a technical and analytics subject matter expert, providing guidance on cloud data platforms, advanced analytics methodologies, and reporting solutions.
Partner with technology, data engineering, and business stakeholders to implement scalable analytic capabilities and data products.