Manager, Medical Economics

CVS Health

Medical Economics Manager at CVS Health supporting audits related to provider contracts. Collaborating with internal stakeholders and external provider organizations to validate accuracy and drive resolution of audit findings.

Posted 5/22/2026full-timeRemote • Alabama, Arizona, Connecticut, Florida • 🇺🇸 United StatesMid-LevelSenior💰 $54,300 - $145,860 per yearWebsite

About the role

Key responsibilities & impact

Perform audits of provider‑related data, and financial arrangements to validate compliance with contract terms, internal policies, and regulatory requirements
Review and assess documentation, calculations, data sources, and system outputs related to Medical Economics processes
Independently identify audit exceptions, root causes, and risk levels, ensuring findings are supported by clear evidence
Apply defined audit criteria, scoring methodologies, and sampling approaches consistently across audits
Serve as a primary audit point of contact within MEU for provider groups, delegated vendors, and network partners when audit activity requires external coordination
Communicate audit scope, findings, and remediation expectations clearly and professionally to external providers and internal network teams
Document audit results, findings, and remediation actions in audit tools, trackers, and workpapers with a high level of accuracy and clarity
Track findings through remediation and verification, escalating risks and delays as needed

Requirements

What you’ll need

5+ years working experience
Bachelor’s degree or equivalent experience in healthcare administration, finance, business, economics, or a related field
Experience performing audits, quality reviews, or compliance assessments within healthcare, payer operations, provider networks, or vendor management
Ability to analyze data, documentation, and calculations to identify discrepancies and assess financial or compliance impact
Demonstrated ability engaging with external partners or providers through clear written and verbal communications
Demonstrated ability to manage multiple audits or workstreams while meeting deadlines

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
comprehensive benefits package designed to support physical, emotional, and financial well-being of colleagues and their families

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

auditingdata analysisfinancial assessmentcompliance assessmentquality reviewrisk assessmentdocumentation reviewscoring methodologiessampling approachesaudit tools

Soft Skills

communicationprofessionalismproblem-solvingattention to detailtime managementcollaborationorganizational skillscritical thinkingengagementmultitasking