At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.This position is classified as hybrid and can be filled in one of the following CVS office locations. Hartford, CT., Woonsocket RI., Atlanta, GA., Irving, TX., Scottsdale, AZ., or Northbrook, IL. Additional CVS office locations may be considered at management discretionPosition Summary
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This fast-paced, high visibility, executive-focused analytical role will evaluate changes to medical policy and their interactions with our network relationships to support the overarching Medical Economic mission statement of reducing medical costs and medical costs trends to provide more affordable healthcare to Aetna and CVS Health members while improving quality and access.As part of the Medical Economics National team, you will have the opportunity to present key trends, financial performance, tools and analyses with a broad MEU audience (including direct exposure to VP-level leadership). The MEU National team is accountable for working collaboratively across MEU to analyze, draw conclusions, and communicate the financial impact resulting from changes in Aetna's clinical policies and network provider agreements.
- Individual contributor that applies wide-ranging knowledge and experience of own job area within business unit or function, and may have advanced knowledge and practical experience of specific technical areas applied within the context of a similar industry or type of organization.
- Works collaboratively to analyze, draw conclusions, and communicate the financial impact resulting from changes in Aetna's medical policy and the subsequent provider impact.
- Set objectives and deliver results that have a significant impact within the context of a wider operational area.
- Plans and sets objectives to deliver responsibilities that have a direct effect on the business results within the context of the functional area that the job is in.
- Requires independent completion of work, where discretion is required within broader established operational boundaries of the function that job is in.
- Recognized as subject matter expert.
- Typically works independently and manages projects.
- Requires strong communication skills, creating an environment of teamwork and continual process improvement internal to MEU and external constituents.
- Provides Local Market support to Medical Expense Review teams on medical policy and provider topics
Complex data collection, modeling & analysis.
Experience working with Excel, MS-Access and Web-based query tools.
Prioritizes & manages multiple projects while managing customer expectations and business priorities.
Work collaboratively and build relationships with colleagues.Preferred Qualifications
Knowledge of:
- 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 communication/presentation skills.
- Advanced software and programming skills.
Bachelor's Degree in business, finance, or related field OR equivalent work experience. Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:$66,330.00 - $145,860.00This 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.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an 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.