CVS Health

Medical Economics Manager – Medical Expense Review

CVS Health

full-time

Posted on:

Location Type: Hybrid

Location: Hartford • Connecticut • Illinois • United States

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Salary

💰 $60,300 - $145,860 per year

About the role

  • Provide consultative support and medical cost-based analysis of markets and network initiatives.
  • Perform complex analytical projects to research utilization and unit cost medical cost drivers.
  • Turn data into usable information by telling the story through data visualization.
  • Support the development of scoreable action items by identifying outlier cost issues.
  • Lead discussions and presentations with the local market plan leadership and within Medical Economics about medical cost drivers and mitigating cost opportunities.
  • Be accountable for tracking and documenting all aspects of related work from beginning to end of a project.
  • Work with Excel, MS-Access, Power BI, and Web-based query tools (data warehouse).

Requirements

  • 5+ years of experience in analytics or finance equivalent experience.
  • Extensive knowledge of managed care and how provider reimbursement policies relate to the control of medical claims costs.
  • Full 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).
  • Advanced software and programming skills.
Benefits
  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • 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.
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
data analysisdata visualizationmedical cost analysisutilization researchcost driver analysisprovider reimbursement policiesprovider contractsregulatory impact analysisadvanced software skillsprogramming skills
Soft Skills
consultative supportpresentation skillsleadershipaccountabilitycommunication