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Manager, Medical Cost Management

AT CVS Health
CVS Health

Manager, Medical Cost Management

Springfield, IL

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Role Description:

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CVS Healthspire Value-Based Services is a new and rapidly scaling business within CVS Health where the best in class population health capabilities across Health Care Delivery are deployed to manage members delegated to our risk-bearing entity. These members are Medicare Advantage members in one of our contracted geographies and don't currently have enhanced value-based care relationships with primary care providers. At CVS Healthspire Value-Based Services, we are focused on ensuring our delegated members are receiving high-quality and cost-effective care.

The Manager, Medical Cost Management reports to the Vice President, Medical Cost Management.

The ideal candidate is a highly organized, self-starter, enjoys solving challenging problems, uses data to drive insights, and excels in a fast-paced environment. This will be a high-visibility role requiring significant cross-team collaboration within Population Health and other CVS and Oak Street corporate teams (e.g., Business Intelligence, Care Services, Clinical Quality, Managed Care Operations, etc.).

Core Responsibilities:
  • Supports one or more high-impact care model initiatives spanning patient engagement, patient outreach, scheduling, clinical documentation, quality/STARs, and third-party medical costs.
  • Partners with clinical and operational field leaders, and has regular communication with senior leadership.
  • Other duties, as assigned.
Required Qualifications:
  • 3+ years of consulting or other applicable experience in healthcare / population health
  • Strong interpersonal skills that support effective stakeholder engagement
  • Strong written communication skills; highly proficient with Microsoft PowerPoint
  • Analytical and data savvy; highly proficient with Microsoft Excel
  • Ability to organize projects to outline clear owners, expectations, timelines
  • Ability to develop business cases, ROI analysis, and financial analysis
  • Passion for excellence, willing to go the extra mile to achieve objectives and ensure consistently high quality work product
  • Quick learner comfortable with a high level of ambiguity
  • Ability to succinctly summarize and synthesize large amounts of information
  • Strong accountability and discipline against timelines and deliverables
  • Collaborative working style, able to work cross functionally
  • Bachelor's degree required
  • US work authorization
Preferred Qualifications:
  • Tableau experience a plus
  • SQL and/or Python experience a plus
Pay Range

The typical pay range for this role is:

$66,330.00 - $145,860.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 11/30/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Springfield, IL, USA
Job ID: CVS-R0430007
Employment Type: Other

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • HSA
    • HSA With Employer Contribution
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Fertility Benefits
    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
  • Financial and Retirement

    • 401(K) With Company Matching
  • Professional Development

    • Tuition Reimbursement
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Diversity, Equity, and Inclusion Program