Manager; Medical Economics - Medicaid

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Position Summary

This role on the NSPE Value Based Analytics team supports Aetna’s Medicaid segment. Join this fast-paced team that works closely together to promote the development and growth of value based contracts across Aetna’s 16 Medicaid plans.

Responsibilities may include : Querying and analysis of complex provider claim, financial and other data to support VBC negotiations / renegotiation and ideation of new VBC arrangements, including complex vendor programs.

Creation of ad-hoc reports and analysis including financial performance, ROI analysis, opportunity sizing, etc. Support the administration of established VBCs including financial reconciliation, payment support, provider-facing support such as trouble-shooting provider issues and problem-solving.

Required Qualifications

• Bachelor's degree or equivalent experience
• 3+ years of prior, relevant work experience
• Seeking a detail-oriented individual with strong analytical and problem-solving skills.
• Ability to work independently and handle multiple priorities in a fast-paced environment.
• Excellent written and verbal communication skills. Must be able to translate complex data into actionable information and communicate effectively to varied audiences including providers and internal business partners.
• Excellent Excel skills required.

Preferred Qualifications

• Prior experience in Medicaid and / or VBC preferred. Knowledge of managed care, provider contracts and provider reimbursement methodologies preferred.
• Prior experience with QNXT preferred.
• Ability to query data (using SAS, SAS EG, SQL or other tool) preferred
• Education
• Bachelor’s degree or equivalent work experience required

Pay Range

The typical pay range for this role is :

$60,300.00 - $139,200.00

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.

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.