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Senior Manager Medical Benefit Opportunity Analysis

at CVS Health

Posted: 3/18/2019
Job Reference #: 931720BR

Job Description

Job Title :
Senior Manager Medical Benefit Opportunity Analysis
Job ID :
Location :
RI - Woonsocket
Street Address :
100 Scenic View
Category :
Description :
Job Description
Provides oversight for the team and processes that support opportunity analysis (OAs) for CVS Health’s medical benefit management products (e.g. NovoLogix, Accordant, Site of Care and Drug Benefit Alignment, Medical Rebates, etc). Is responsible for maintenance and evolution of methodologies and models used across all CVS Health medical specialty management and Accordant population health management programs. Ensures the OA deliverables demonstrate the value of the program offerings specific to each client population, and are executed accurately and efficiently/timely. Responsibilities include leading a team of analysts to deliver customized, modeled and data-driven OAs to existing and prospective CVS Health clients.


Required Qualifications
Needs to be able to translate patient interventions into analyses that simulate the expected value of management programs for prospective clients.
* Strong experience leading analytical projects across functional teams, including coaching and feedback of other team members on analytic approaches;
* Experience in maintaining and enhancing reporting templates, models, algorithms, methodologies, and assumptions;
* Experience developing, implementing, testing and maintaining reporting of program opportunities to internal and external audiences;
* Excellent problem solving skills and ability to construct analytic solutions to business problems;
* Experience with data manipulation with SAS and retrieving data from large databases with SQL, or similar data access, manipulations and statistical analysis tools;
* Excellent written and oral communication skills, ability to interact with and influence decision-making by non-analytical business audiences;
* Experience analyzing and manipulating medical claims, pharmacy claims, and eligibility data

Preferred Qualifications
Experience loading and transforming (ETL) external claims and eligibility extracts, to standard data model
* Background in supporting transfers of large data files from external sources, adhering to legal guidelines for handing sensitive healthcare data

5-8 years of experience required
8-10 years preferred

Bachelor's Required
Masters or Doctorate
Other Certificates or Licenses
Advanced degree in Business, Epidemiology, Biostatistics or HealthCare Administration preferred.

Business Overview
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units - MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.

CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking Advice and Counsel

CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.

For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website:

Application Instructions

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