Data Driven Medicare Advantage Strategist

3 weeks ago


West Hartford, Connecticut, United States CVS Health Full time

At CVS Health, our mission is to provide innovative solutions that improve the lives of our patients and communities. We are seeking a skilled Data Driven Medicare Advantage Strategist to join our team and contribute to our commitment to delivering enhanced human-centric healthcare.

As a Data Driven Medicare Advantage Strategist, you will play a critical role in supporting our Medicare Advantage Value-Based Contracts (VBC) strategy. You will work collaboratively with cross-functional teams, including Network, Finance, Actuarial, and Patient Management, to promote the development, growth, and execution of value-based contracts across our MA business.

Responsibilities will include:

  • Performing complex medical and financial cost analysis to evaluate real-time medical cost and revenue drivers and develop strategic options and opportunities to favorably impact performance of our Medicare Value-Based Contracts.
  • Partnering and consulting with Actuarial, Network, Patient Management, and Segment teams to provide medical cost analysis to assess the effectiveness of managing costs, creating and implementing plans to effectively manage medical costs based on analysis or trends.
  • Demonstrating knowledge of external economic, demographic, regulatory, and other Medicare business drivers as well as the overall competitive environment.
  • Supporting the implementation and creation of enterprise initiatives to enhance VBC performance and mitigate unfavorable drivers of poor provider experience.
  • Presenting complex information in a way that multiple levels within an organization can understand and utilize to make appropriate decisions to meet business objectives.

This role requires a Bachelor's degree or equivalent experience along with 3+ years of relevant work in the industry. Prior experience in Medicare Advantage is preferred, as well as advanced skills in Excel, MS-Access, and Web-based query tools (MCM, data warehouse). Ability to learn new technologies is also essential.

We offer a competitive salary range of $66,145.860.00, with a bonus, commission, or short-term incentive program in addition to the base pay. Our benefits package includes a fully-paid term life insurance plan, short-term and long-term disability benefits, and a 401(k) retirement savings plan. We also offer numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.

We anticipate the application window for this opening will close on 11/15/2024. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws. If you are a motivated and detail-oriented professional looking to make a meaningful impact in the healthcare industry, we encourage you to apply for this exciting opportunity.



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