Description
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.
The Senior Manager of Medical Economics is a critical leadership role responsible for analyzing medical costs, quality outcomes, and utilization drivers to support the delivery of value-based primary care. This individual will plan, conduct, and lead analyses of healthcare claims data to identify root causes of trends and anomalies, translating complex datasets into actionable strategies for executive and field leadership.
Key Responsibilities:
- Develop financial models and forecasts related to healthcare costs and utilization for executive review and strategic planning.
- Project future healthcare expenditures, estimate potential savings, and evaluate the financial impact of various clinical initiatives and interventions.
- Design and maintain comprehensive reports and dashboards to monitor key performance metrics and critical economic drivers.
- Collaborate with cross-functional teams (Finance, Clinical, Data Science) to identify cost-saving opportunities and optimize value-based payment models.
- Evaluate the effectiveness of value-based care initiatives on overall medical cost and quality outcomes to assess clinical and financial ROI.
- Partner with Data Engineering to develop long-term data assets and infrastructure for scalable, advanced analytics enablement.
- Ensure all analyses and reporting adhere to regulatory requirements and industry standards for medical economics.
Required Qualifications:
- 7 years of experience in quantitative analysis, healthcare analytics, or medical economics within the healthcare or payer industry.
- Deep subject matter expertise in value-based care, population health, and medical claims data (ICD-10, CPT).
- Advanced proficiency in SQL for complex data extraction, manipulation, and analysis.
- Proven track record of leading cross-functional teams and presenting executive-ready insights to C-suite and clinical leadership.
- Exceptional problem-solving, decision-making, and project execution skills.
Preferred Qualifications:
- Proficiency with business intelligence tools such as Tableau or Power BI.
- Experience in value-based care analytics for Medicare Advantage and Traditional Medicare programs (e.g., ACO REACH, MSSP).
Education:
- Bachelor’s degree in a STEM field, finance, economics, or a related analytical discipline (advanced degree preferred).
Pay Range: $82,940.00 - $182,549.00
This 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.