Analyst, Medical Economics (Medical Expense Review)

Analyst, Medical Economics (Medical Expense Review)

15 Dec 2024
Connecticut, Hartford, 06101 Hartford USA

Analyst, Medical Economics (Medical Expense Review)

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Position SummaryIt’s an exciting time for our Medical Economics team at CVS Health. As a growing team in a Fortune 5 company, we can provide amazing benefits to our employees along with continuous career development. This includes flexible work location, a great work-life balance, and a competitive salary. You will also be able to flex your analytics and consultative skills to positively impact our patients’ health.As a Medical Economics Analyst, you will provide consultative support and medical cost-based analysis of markets and network initiatives. You will be responsible for consulting with network and clinical management on opportunities to improve our company’s discount position and strategic cost and utilization initiatives and is essential to managing conflicting priorities and multiple projects. As part of the Medical Expense Review (MER) team, you will prepare for monthly presentations, and manage both long and short-term projects, working collaboratively with local market leaders to accomplish tasks and goals that will improve the care we give our patients.You will also: Analyze and research utilization and unit cost medical costs drivers Turn data into usable information by telling the story through data visualization Support the development of scoreable action items by identifying outlier cost issues 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 Work with Excel, MS-Access, Power BI, and Web-based query tools (data warehouse)Required Qualifications

6+ months of experience in analytics or finance or equivalent experience.

Preferred Qualifications

Experience in within the healthcare industry

Experience 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)

Experience working with medical and pharmacy claims

Education

Bachelor's degree or equivalent work experience required.

Pay RangeThe typical pay range for this role is:$43,888.00 - $93,574.80This 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.In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.For more detailed information on available benefits, please visit Benefits | CVS Health (https://jobs.cvshealth.com/us/en/benefits)We anticipate the application window for this opening will close on: 01/13/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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