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Senior Informatics Manager

AT CVS Health
CVS Health

Senior Informatics Manager

Harrisburg, PA

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. Position Summary This position will support East Coast hours, starting by 9:00 am ET. This is a hybrid position. However, if you're not within a reasonable commute to an Aetna office, don't worry - remote candidates are welcome too.Aetna Clinical Enablement (ACE) has an exciting opportunity for a Senior Informatics Manager to join our HEDIS Technology Innovation Team. The Healthcare Effectiveness Data and Information Set (HEDIS) is one of the most widely used healthcare quality data sets in the country. HEDIS reporting is a requirement for NCQA Health Plan Accreditation, CMS Medicare Advantage, Medicare Stars, Exchange, Medicaid, and many states. HEDIS measure results are used within the enterprise and externally to drive quality initiatives that improve the health of Aetna's members. The HEDIS Technology Innovation Team is responsible for supporting internal stakeholders, measure and run issue research and resolution, identifying measure and technology opportunities, providing HEDIS measure data and research to support initiatives, and the business oversight of HEDIS technology projects such as the transformation of HEDIS reporting to digital.In this role you will apply HEDIS measure, data, and technical platform knowledge to perform complex research and analytics in support of internal HEDIS reporting for high profile stakeholders such as Medicare Stars and Medicare VBC. You will apply CVS Heart-at-Work behaviors to work successfully in a team-based environment where team members work together and support each other to achieve greater excellence. Responsibilities

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  • Product Owner of one or more HEDIS Technology projects: champion business requirements and partner with HEDIS IT to design, build, and test the appropriate solution in the required timeframe.
  • Google Cloud Platform tenancy administration to provide cost oversight, education, and implementation of best practices to users (only 1-2 people on the team will serve in this capacity).
  • Conduct end-to-end analysis' on data source pipelines and measure logic to identify opportunities for rate improvement.
  • Collaborate with stakeholders to understand their business needs and provide recommendations for solutions.
  • Create automated solutions for the validation of measure runs.
  • Perform research and analysis of HEDIS aggregate and member level data in a relational database environment, including writing queries to identify trends, draw conclusions, make recommendations, and validate results. Subsequently, compile and communicate the information to internal stakeholders.
  • Perform validation of measure run results to identify problems prior to releasing to stakeholders.
  • Troubleshoot measure run issues to identify root cause and collaborate with HEDIS IT to identify next steps for resolution.
  • Collaborate with HEDIS IT partners to implement measure updates and other updates that pertain to HEDIS reporting for Medicare Stars. Monitor progress of the updates and validate results.
  • Serve as a subject matter expert for Medicare Star measures to provide information and education to internal stakeholders.
  • Provide proactive communication to stakeholders on upcoming changes that will impact their processes.
The most successful candidates will display these traits:
  • Expertise writing SQL queries to work with large complex data sets
  • Ability to understand and probe into technical processes and data
  • Experience working with health care data sources (enrollment, claims, lab, etc)
  • Be organized and exhibit attention to detail
  • Ability to manage conflicting priorities and multiple projects concurrently
  • Ability to work independently under general direction
  • Accountable for meeting commitments
  • Driven to provide an excellent customer experience for stakeholders.
  • Experience with Agile methodology in the Product Owner role
  • Successful track record of managing technical projects from discovery to delivery
Required Qualifications
  • 5+ years of data analytics experience
  • 3+ years experience with health care data (enrollment, claims, lab) in a data warehouse environment
  • 3+ years experience using advanced SQL querying abilities in a large relational database environment including the ability to handle large datasets from multiple data sources
  • 3+ years experience creating reports and pivot tables in Excel
  • Ability to interpret technical specifications
  • Ability to communicate technical concepts to non-technical audiences (written and verbal)
  • Adept at probing into granular details of big data and complex technical processes
  • Strong problem solving skills and critical thinking ability
  • Strong collaboration and communication skills within and across teams
Preferred Qualifications
  • Experience with HEDIS or other quality measurement program
  • Experience with Google Cloud Platform (GCP) administration
  • Experience with BigQuery data platform
  • Agile Product Owner experience
Education

Bachelor's Degree or equivalent work experience requiredPay Range

The typical pay range for this role is:$75,400.00 - $182,549.00

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. This position also includes an award target in the company's equity award program.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.
For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 04/07/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Harrisburg, PA, USA
Job ID: CVS-R0535433_1002
Employment Type: Full Time

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