Medical Economics Project Manager

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 colleagues who care deeply, innovate with purpose, hold themselves accountable and prioritize safety and quality in everything they do.

Position Summary

Performs complex medical economic projects, such as 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.

Required Qualifications

• 3+ years demonstrated leadership and/or project management experience
• 3+ years of healthcare and/or analysis experience.

Preferred Qualifications

• 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.

Education

Bachelor's Degree or equivalent work experience required.

Anticipated Weekly Hours

40

Time Type

Full-time

Pay Range

$46,988.00 - $102,000.00

Benefits

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.