Manager, Business Analytics

CVS Health is dedicated to shaping a connected and compassionate health experience. The Manager of Business Analytics will develop and deliver decision support tools and insights by creating analytics and reporting assets to support financial and operational decision-making for Retail Health leadership.

Responsibilities:

• To develop and deliver decision support tools & insights via creating and sustaining analytics & reporting assets and leveraging business intelligence resources in support of contracting, financial and operational strategic decision-making by Retail Health leadership
• This involves extracting, analyzing, and interpreting contracting, utilization, financial, and clinical/quality data from various sources to support nationwide payer contract negotiations, market penetration, conversion, and expansion strategies, value-based care initiatives, and other quantitative analysis & reporting requirements
• These activities require advanced technical, analytical, and consultative skills, advanced proficiency in using business intelligence tools, and extensive knowledge of healthcare business models and healthcare delivery systems
• Responsible for the discovery and deployment of applicable solutions to address business needs and serving as a gatekeeper within cross-functional workflows with key internal stakeholders operating via an external-facing lens
• Act as the SME for quantitative projects and qualitative workflows by driving data ingestion, storage & documentation protocol, data pre-screening & proactive risk mitigation, and task coordination & implementation

Requirements:

• 5+ years of experience in healthcare finance, strategy, analytics, economics, or related field
• Knowledge of healthcare reimbursement methodologies ranging from volume-based (fee-for-service) to value-based (quality performance incentives) arrangements
• Knowledge of statistical analysis techniques, tools and modeling
• Advanced proficiency using business intelligence resources such as Tableau, Power BI, SAS/SQL, and Microsoft Office
• Ability to maintain complex financial models to support contracting, budgeting and forecasting activities
• Collaborate with cross-functional teams to identify quantitative needs, mitigate risk, and sustain workflow synergy and alignment
• Proven problem-solving skills, critical and independent thinking, and ability to navigate ambiguity
• Ability to work optimally in a fast-paced matrixed environment and produce high-quality timely deliverables
• Ability to build trusting relationships with stakeholders and demonstrate a proven record in establishing and sustaining collaborative workstreams
• Must be a self-starter demonstrating high agility and capability to pivot work priorities within a dynamic evolving environment
• 6-8 years of experience in healthcare finance, strategy, analytics, economics, or related field
• Master's degree in healthcare administration, finance, economics, analytics, or any other related field
• Experienced working with large datasets and creating relational databases from multiple sources ensuring data integrity and interoperability
• Advanced financial modeling skills including designing and leveraging scenario planning & sensitivity analysis schematics
• Excellent communication skills (written and oral) and ability to communicate complex financial and contracting information to internal stakeholders ensuring clarity and understanding
• Knowledge of revenue cycle activities such as fee schedule configuration & billing, claims submission & processing, and denials & appeals