Medical Economics Analyst, Senior
We are seeking an analytical professional to join our Medical Economics - Value Based Contracting (VBC) team. The primary goals of this team are to provide analytical support for Aetnas value based contracts, work collaboratively with business units across the company to provide medical cost and outcomes focused analysis, modeling and business decision support. This position will be involved in all aspects of the value based lifecycle from contract negotiation through reconciliation and settlement. This is a highly visible consultative role without outside provide partners willing to engage in value based care opportunities.
Fundamental Components/Job Description:
* Analyze and research medical costs drivers.
* Support the development of scoreable action items by identifying outlier cost issues.
* Consult with network and clinical management on opportunities to improve companys discount position and strategic cost and utilization initiatives.
* Perform drill-down analysis to identify medical cost trend drivers; advise network of contracting opportunities to mitigate future trends.
* Own, track and document all aspects of related work from beginning to end of a project.
* Need experience with cost trends and analysis within Claims.
1 or more years of healthcare analytics experience
1 or more years with MS Suite (specifically pivot tables and v look ups)
* SAS Enterprise Guide experience preferred
* Analytical financial experience.
* An understanding of the healthcare industry
* Familiarity with key managed care functions including provider contracting, benefit design, medical management as well as knowledge of business functions and impact on financials (underwriting, sales, product development, network management) is also strongly preferred.
* 3 or more years experience in the managed care industry with knowledge of provider contracting, provider reimbursement, patient management, product and benefits design.
* Advanced skills in Excel, MS-Access and Web-based query tools (data warehouse).
* Ability to learn new technologies.
* Strong analytical ability and familiarity with advanced financial and healthcare concepts.
* Demonstrates critical thinking and expresses ideas clearly, concisely and logically from a cross functional perspective.
* Ability to manage conflicting priorities and multiple projects concurrently.
* Demonstrates initiative, innovation and leadership in achieving results.
Bachelors degree required; preferably in business, finance or other related field.
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.