Manager, Medical Economics
Today• Madison, WI
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
Are you a data-driven problem solver with a passion for healthcare economics? Join our team as a Manager, Medical Economics and play a pivotal role in shaping cost-effective healthcare strategies. You'll work both independently and collaboratively on high-impact projects-like contract rate modeling-that directly influence business decisions and improve patient outcomes.
What You'll Do
- Lead complex medical economic initiatives from concept to completion, ensuring alignment with strategic goals.
- Drive innovation in cost management through the development of analytical models, policies, and programs.
- Partner with Network Management to analyze contracted rates and identify actionable insights that optimize provider reimbursement and control medical costs.
- Design market-specific provider reimbursement schedules that reflect local dynamics and strategic priorities.
- Deliver high-value reporting-both standard and ad-hoc-for risk assessment, budgeting, and forecasting, including hospital chargemaster analysis.
- Coordinate rate approvals and pricing strategies for the most complex contractual arrangements.
- Communicate strategic insights across products, segments, and markets to diverse stakeholders, turning data into decisions.
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5+ years demonstrated leadership and/or project management experience
5+ years of healthcare and/or analysis experience.Preferred Qualifications
• Extensive knowledge of managed care and how provider reimbursement policies relate to the control of medical claims costs.
• Full 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:
• Advanced communication/presentation skills.
• Advanced software and modeling skills, e.g. Microsoft Excel and Access, SAS.
• Strong analytical ability and familiarity with advanced financial and healthcare concepts.
• Ability to manage conflicting priorities and multiple projects concurrently.Education
Bachelor's Degree or equivalent work experience requiredThis is a remote role located in the East or Central USA and is not available for sponsorship at this time. Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:$54,300.00 - $159,120.00This 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.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.
Client-provided location(s): Madison, WI
Job ID: CVS-R0674536_1031
Employment Type: OTHER
Posted: 2025-08-17T19:37:02
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
Office Life and Perks
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