Medical Economics Lead Analyst

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

We are seeking an analytical professional to join our Medical Economics - Medical Expense Review (MER) team. The primary goals of this team are to a) identify and communicate with leadership specific provider, procedure and population level trends and outliers impacting the health plans medical cost trends, and b) analyze and size potential savings initiatives in coordination with clinical, finance, and network leads.Required Qualifications

• Applicants must have relevant analytical financial experience.
• Minimum of 3-5 years' experience with key managed care functions including provider and population analytics, provider contracting, benefit design, medical management as well as knowledge of business functions and impact on financials.
• Advanced skills in Excel, and Web-based query tools to pull and analyze ad-hoc data.
• Critical skills within Excel include use of pivot tables to sort and organize data, use of formulas for financial modeling and data tagging, and creation of data visualizations to effectively communicate the trend story
• Essential skill as reporting "super user" - able to easily navigate, comprehend, and tease out findings with a variety of enterprise reporting tools.
• 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.
• Ability to learn new technologies and analytic approaches.

• Skills within SQL Coding that may be beneficial will include ability to run ad-hoc analyses to answer specific clinical or financial questions for the Account, Finance, UM, or Network Teams.
• 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.
• An understanding of the healthcare industry is strongly preferred, including differentiating between inpatient and outpatient services, facility and professional claims, and impacts from population dynamics.
• Underwriting, sales, product development, network management is also strongly preferred.
• SQL Coding experience preferred but not required.

• Bachelor's Degree in business, finance, or related field OR equivalent experience.

• 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.