Medical Economics Cnslt (Fully Remote)
** Fully Remote role, work from home anywhere **
The Medical Economics Consultant will support key projects and initiatives in the Behavioral Health organization. This experienced professional will work in collaboration with financial, actuarial and MEU teams to develop, interpret and favorably impact national and local market behavioral health medical cost trend. The Consultant will act as a key liaison to the MEU and serve as a behavioral health medical cost SME to various business teams. The ability to translate and synthesize financial and economic data into consumable content for business decision-making and leadership presentations is an essential function.
* Conduct ad-hoc and ongoing analyses in support of
Behavioral Health business
* Scoreable Action Item management - including sizing,
modeling, and recordkeeping of medical cost savings
* Serve as a Behavioral Health medical cost SME for
business and clinical teams
* Work collaboratively with Performance Management
teammates to develop measures, scorecards, and
analyses for large projects
* Work collaboratively with MEU and actuarial to generate
insights and reports to support Behavioral Health
* Prepare Behavioral Health content to support other MEU
national meetings (MENTOR, SAI, etc.)
* Leverage data and analytics to solve complex business
problems, demonstrate value and measure outcomes
* Strong organizational skills required
- Minimum of 3-5 years of experience claims analysis,
medical cost management and analysis, or Aetna clinical
- 3+ years of experience within analytics, finance, medical
economics, underwriting or related field.
- Strong data manipulation and analysis expertise
- Must be proficient in SQL, Access, and Excel.
- Experience working with medical or pharmacy claims
(behavioral health experience a plus)
- Strong organizational skills required
- Experience in the data visualization tool (Tableau or Power
- Bachelor's Degree in business, finance, mathematics or
related field preferred or 3 to 5 years equivalent work
experience in the healthcare industry
At Aetna, a CVS Health company, 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 are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. 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.