Medical Economics Senior Manager

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

This analytical position is responsible for supporting complex Capitation analyses that support our strategic goals for Medicaid, Medicare, IFP and commercial, and working collaboratively with the Network to determine the financial impact resulting from changes in provider contracts and payment methodologies. This position is part of a team that provides focused analytical research, complex financial modeling and business decision support related to medical cost. Since data mining and "what-if" scenarios are the regular analytical approach, this position is a perfect fit for somebody who is thinking outside of the box and who is able to turn data into useful information.

Owning complex provider contracts and following through full life cycle from pricing, implementing rates, auditing, monitoring leakage, etc. Also should include external exposure.

This is a role in a very fast paced and dynamic environment with a high performing team and there are high expectations.

Required Qualifications

• 7+ years of prior experience in the industry with decision support, including presentation skills for provider (EXTERNAL) and business partners with less financial/technical skillsets
• 5+ years of SAS and SQL skills to pull custom data for analysis.

Preferred Qualifications

• Organization skills to keep projects on schedule and tracking results
• Expertise in multiple areas of provider contracting/reimbursement, analysis, modeling & reporting; Extensive & diverse knowledge of healthcare data, metrics & coding structures
• Understanding of both Commercial and Medicare plans to help network partners to make sound decisions to drive solutions.
• Present complex information in a way that multiple levels within an organization can understand and utilize to make appropriate decisions to meet business objectives.

Education
Bachelor's degree in Math, Actuarial Science, Economics or another related degree preferred/specialized training/relevant professional qualification or equivalent (HS Diploma and 4 years of experience) required

Pay Range
The Typical Pay Range For This Role Is
$75, $165,954.00

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great Benefits For Great People
We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

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We anticipate the application window for this opening will close on: 12/19/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.