VBC Specialty Analytics Deal Owner

CVS Health • Hartford, CT

5d • Remote

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 Are you passionate about improving healthcare outcomes and have the skills to drive value-based initiatives? If yes, we encourage you to apply. This position offers broad exposure to all aspects of the company’s business and significant interaction with business leaders. Condition-specific Value-Based Care (VBC) models are an expanding focus for Medicare business, with a growing number of Provider Partners and eligible members, these specialty deals require a high-level of support. The deal owner would be responsible for eligible member attribution analyses, financial reconciliation, and collaborative efforts to deliver focused analytical research, complex financial modeling, and business decision support. You will provide oversight of all activities related to Provider Partners, ensuring timely and actionable data, appropriate eligibility criteria is met, reconciliations and analysis to support contract performance. The ideal candidate brings extensive VBC solutions, a passion for member focused programs, expert data mining, outside the box/adaptable thinking and turning data into useful information. A proactive, self-driven approach and the ability to thrive in a fast-paced, collaborative environment are critical for success. This role offers broad organizational exposure and frequent engagement with senior leaders. This role is work at home flexible. The candidate will be required to work according to Eastern time zone hours.

Requirements

• 7+ years of experience in healthcare analytics and Medicare plans; particularly in value-based care financial models and risk-based arrangements.
• 3+ years of experience using healthcare data including medical, pharmacy, lab, survey, and utilization data as well as experience with Medicare plans
• The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment.
• The candidate will be required to work according to Eastern time zone hours.

Nice To Haves

• Experience in Value Based Care financial models
• Experience in Risk-Based arrangements and Value-Based Care in Government services
• 3+ years of experience in SAS, Excel, SQL, Power BI or GCP
• Demonstrated commitment to diversity, equity, and inclusion through modeling inclusive behaviors and proactively managing bias.
• Ability to manage multiple projects using sound organization skills to track results and deliver projects on schedule
• Mastery of problem-solving and decision-making skills, with a growth mindset and commitment to continuous personal development.
• Knowledge of clinical models, technical attribution logic, and medical management concepts would be a plus.

Responsibilities

• Establish and maintain productive, professional relationships with complex, high-value initiatives and high-risk revenue-generating Provider Partners.
• Work collaboratively across Network, Value Based Solutions, and Finance to meet all constituent questions and individual deal needs on a timely basis.
• Educate internal and external stakeholders to ensure compliance with contract terms and expectations.
• Work collaboratively to develop analytic processes, workflows, and strategies that drive data integration, innovation, and continuous improvement.
• Analyze Provider Partner performance against business and team objectives.
• Monitor and perform complex financial, clinical, cost, and efficiency assessments against targets.
• Effectively communicate complex information in a way that is easily understood and actionable by multiple levels within an organization, enabling decision-making that meets business needs.

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