Senior Manager, VBC Analytics - Medicaid

CO Salary Range: USD 82,940.00 - 182,549.00 per year

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

Aetna is recruiting for a Senior Manger on the Medicaid VBC Analytics team to support VBC partnerships throughout Aetna's Medicaid segment to deliver on Aetna's Medicaid VBC strategy. As an individual contributor, you will partner collaboratively and cross functionally with Network, health plan and VBC strategy customers as well as multiple business areas and other team members to promote the development, growth and operationalization of effective value based contracts across Aetna's Medicaid plans.Responsibilities may include: Querying and analysis of complex provider claim, financial and other data to support VBC negotiations/renegotiation and ideation of new VBC arrangements, including complex vendor programs. Creation of reports and analysis including financial performance, ROI analysis, opportunity sizing, etc. Support the administration of established VBCs including setup, financial reconciliation, payment support, provider-facing support such as JOC participation and problem-solving.Required Qualifications

• Seeking a detail-oriented individual with superior analytical and problem-solving skills.
• Strong organizational skills, attention to detail, ability to work independently based on strategic direction, and ability to drive resolution across internal and external stakeholders.
• Comfortable to react quickly, change focus when needed, and handle multiple priorities in a fast-paced environment.
• Excellent written and verbal communication skills. Must be able to translate complex data into actionable information and communicate effectively to varied audiences including health plan senior leadership, providers and a multitude of internal business partners.
• Desire to be a member of dynamic team of individuals who work closely together in support of common goals.
• Prior experience handling financial data - claim, revenue, restatement, etc.
• Excellent Excel skills required.
• 8+ years of prior relevant work experience required.

Preferred Qualifications

• Experience querying large data sets such as claims data using SAS, SQL or similar tool.
• Prior experience in Medicaid managed care and/or value based care. Knowledge of managed care, provider contracts and provider reimbursement methodologies.
• Understanding of managed care and how provider reimbursement policies relate to the control of medical claims costs.
• Prior experience with QNXT a plus.

Education

• Bachelor's degree in business, finance, mathematics or related field, or equivalent work experience required

This is a remote or hybrid rolePay Range

The typical pay range for this role is:$67,900.00 - $199,144.00

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. This position also includes an award target in the company's equity award program.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.

For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 10/27/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Denver, CO

Job ID: CVS-R0697160_1004

Employment Type: FULL_TIME

Posted: 2025-09-16T19:48:28