Sr Analyst, Medical Economics

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Performs complex medical economic projects (e.g. contract rate modeling)

Accountabilities include identification and completion of key deliverables to ensure all business objectives are met.

Responsible for the development and implementation of key medical economics business efforts e.g.medical cost initiatives, policies/programs, budget and analytical models.

Partners and consults with Network Management to provide medical cost analysis to assess effectiveness of contracted rates, creating and implementing plans to effectively manage medical costs based on analysis or trends.

Develops market specific provider reimbursement schedules

Oversees the production of both standard and ad-hoc reports used for risk assessment analysis, budgeting, and hospital chargemaster analysis and forecasting.

Coordinates rate approvals and develops pricing for most complex contractual arrangements.

Develops and communicates tactical and strategic plans to satisfy information needs across products, segments and markets to a broad audience

3+ years demonstrated leadership and/or project management experience

3+ years of healthcare and/or analysis experience.

• Knowledge of managed care and how provider reimbursement policies relate to the control of medical claims costs.

• 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).

Skill in:

• Strong communication/presentation skills.

• Strong software and modeling skills.

• Strong analytical ability and familiarity with advanced financial and healthcare concepts.

• Ability to manage conflicting priorities and multiple projects concurrently.

The typical pay range for this role is:

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. 
 

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