[Hiring] Manager VBC Analytics @CVS Health

Role Description

We are seeking a Manager, Medicaid Value-Based Care (VBC) Analytics to support value-based care partnerships across Aetna's Medicaid business and help advance our Medicaid VBC strategy. In this individual contributor role, you will collaborate with Network, Health Plan, and Value-Based Care Strategy teams, along with a broad range of cross-functional partners, to support the development, implementation, growth, and optimization of value-based provider arrangements. The ideal candidate combines strong analytical expertise with healthcare business acumen and a passion for driving measurable improvements in quality, cost, and provider performance.

• Analyze complex provider, claims, financial, and operational data to support value-based care negotiations, renewals, and the development of new provider arrangements.
• Develop and maintain SQL queries, reports, dashboards, and analytical models to evaluate financial and operational performance.
• Support the administration and ongoing management of value-based care agreements, including implementation activities, financial reconciliations, performance monitoring, payment support, and issue resolution.
• Partner with cross-functional stakeholders to identify opportunities to improve provider performance, enhance contract effectiveness, and achieve value-based care objectives.
• Translate complex data into meaningful business insights and actionable recommendations for stakeholders and leadership.

Qualifications

• 5+ years of relevant professional experience in healthcare analytics, finance, value-based care, provider contracting, or a related field.
• Strong analytical, critical thinking, and problem-solving skills with exceptional attention to detail.
• Demonstrated ability to manage multiple priorities, adapt quickly to changing business needs, and work effectively in a fast-paced environment.
• Excellent organizational, written, and verbal communication skills.
• Ability to independently drive workstreams while collaborating across internal and external stakeholder groups.
• Experience developing and executing SQL queries in environments such as BigQuery, SQL Server (SSMS/T-SQL), or similar database platforms.
• Experience converting, optimizing, and validating SQL-based analyses, queries, and stored procedures across cloud-based analytics environments while ensuring data integrity and performance optimization.
• Ability to communicate complex analytical findings to both technical and non-technical audiences, including senior leadership.

Requirements

• Experience working with large healthcare datasets, including medical and pharmacy claims data.
• Experience analyzing healthcare financial performance, including revenue, reconciliations, utilization, and value-based performance measures.
• Knowledge of Google Cloud Platform (GCP).
• Experience supporting Medicaid managed care, value-based care programs, provider contracting, or alternative payment models.
• Understanding of managed care fundamentals and provider reimbursement methodologies.
• Advanced Microsoft Excel skills, including financial modeling and data analysis.
• Experience developing and presenting strategic recommendations and actionable insights to business leaders.

Education

• Bachelor's degree in Data Analytics, Business, Finance, Healthcare Administration, Economics, or a related field, or equivalent combination of education and experience required.

Benefits

• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.