[Hiring] Medical Economics Behavioral Health Lead Analyst @CVS Health

Role Description

We are seeking an analytical professional to join our Medical Economics - Medical Expense Review (MER) team. This individual will focus their time on developing savings analyses for Behavioral Health initiatives led by Medicaid Health Plans and Utilization Management Teams.

• Identify and communicate with leadership specific provider, procedure and population level trends and outliers impacting the health plans medical cost trends.
• Analyze and size potential savings initiatives in coordination with clinical, finance, and network leads.
• Coordinate with BH and Analytics leads across multiple teams to obtain information on actions being taken to drive savings.
• Build savings models to communicate results of the initiatives to leadership.

Qualifications

• 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.
• Advanced skills in Excel and web-based query tools to pull and analyze ad-hoc data.
• Ability to build savings models based on a variety of utilization and cost metrics.
• Critical skills within Excel including use of pivot tables, formulas for financial modeling, and creation of data visualizations.
• Essential skill as reporting “super user” with enterprise reporting tools.
• Comfortable presenting to executive audience with high skill level to build PowerPoint visuals.
• Demonstrates critical thinking and expresses ideas clearly, concisely, and logically.
• Ability to manage conflicting priorities and multiple projects concurrently.
• Ability to learn new technologies and analytic approaches.

Requirements

• Skills within SQL Coding that may be beneficial for ad-hoc analyses.
• Extensive knowledge of managed care and provider reimbursement policies.
• Full comprehension of provider contracts and the impact of the regulatory/legislative environment.
• Understanding of the healthcare industry, including inpatient and outpatient services.
• Experience in underwriting, sales, product development, and network management is preferred.
• SQL Coding experience preferred but not required.

Education

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

Benefits

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