[Hiring] Manager - Medical Policy Business Reporting @CVS Health

Role Description

The Manager, Medical Policy Business Analytics is responsible for managing analytics, reporting, performance measurement, and operational intelligence activities that support Medical Policy and Payment Integrity functions. This role translates healthcare, claims, policy, utilization, and operational data into actionable insights that help inform business decisions, monitor performance, improve operational quality, support affordability initiatives, and strengthen compliance readiness.

The position partners with Clinical Operations, Medical Policy, Payment Integrity, Technology, Finance, Compliance, Quality, and Enterprise Reporting teams to identify opportunities for improvement, support policy governance activities, monitor key performance indicators, and deliver practical data-driven recommendations.

The Manager supports day-to-day analytical work, dashboard development, data validation, root cause analysis, performance monitoring, and business intelligence activities while ensuring deliverables are accurate, timely, and aligned with business priorities.

Qualifications

• 5 + years of experience in healthcare analytics, business intelligence, medical policy, payment integrity, healthcare operations, or related healthcare functions.
• 4 + years of experience leading or coordinating projects, analytical workstreams, reporting initiatives, or cross-functional business activities.
• Advanced analytical, quantitative, and problem-solving skills leveraging AI.
• Experience developing executive dashboards, scorecards, KPIs, and performance reporting.
• Experience performing trend analysis, forecasting, root cause analysis, and performance measurement.
• Ability to coordinate analytical work, manage competing priorities, and influence stakeholders across a matrixed environment.
• Ability to balance day-to-day operational priorities with longer-term business goals.
• Ability to communicate complex analytical concepts to technical and non-technical audiences.
• Strong stakeholder management and relationship-building skills.
• Advanced Microsoft Excel skills.
• Experience with Power BI, Tableau, SQL, SAS, Snowflake, Azure Analytics, or similar tools.

Requirements

• Monitor policy adherence, implementation effectiveness, and compliance with internal controls and regulatory requirements.
• Support policy governance committees through reporting, trend analysis, and metric development.
• Partner with Quality Assurance and Compliance teams to identify and mitigate operational risks.
• Support internal audits, regulatory reviews, corrective action plans, and remediation efforts.

Benefits

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs.
• Other resources, based on eligibility.

Company Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.