Senior Risk Adjustment Informatics Manager

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose : Bringing our heart to every moment of your health.

This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand with heart at its center our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

CVS Health has an exciting opportunity for a Senior Informatics Manager to join our dynamic Medicaid Risk Adjustment Analytics team! In this role you will provide complex analytics and reporting to address business questions regarding population health management, health and economic outcomes, and other business needs.

Responsibilities

Perform analysis to identify and prioritize members outreached for prospective and retrospective programs

Identify opportunities to optimize risk scores, while maintaining compliance with CMS standards and State specific methodologies

Build reports and dashboards to track risk adjustment programs, and evaluate the effectiveness and quality of those initiatives

Provide analysis and recommendations for process improvements

Collaborate with internal business partners on risk adjustment programs

Assist in performing analysis used in the development of program sizing and financial projections

Required Qualifications

8+ years of analytical experience working with large complex data sets

Experience working with healthcare claims data, or knowledge of health insurance concepts

Working knowledge of CPT, ICD, and NDC codes

5+ years’ experience in technical programming fundamentals in either SQL, SAS or similar programming language

Able to manage multiple tasks / projects with competing priorities

Effective communication skills (verbal, written, presentation, interpersonal) with all levels / types of audiences

Preferred Qualifications

Knowledge of government-regulated healthcare programs such as Medicaid or Medicare

Risk Adjustment experience / knowledge

Education

Bachelor's Degree or equivalent work experience required

Pay Range

The typical pay range for this role is :

$75,400.00 - $190,700.00

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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.

The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.

The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits.

CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.

As for time off, Company employees enjoy Paid Time Off ( PTO ) or vacation pay, as well as paid holidays throughout the calendar year.

Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.