Manager, Business Analytics

CVS Health is dedicated to building a world of health around every individual, emphasizing a connected and compassionate health experience. The Manager, Business Analytics will develop decision support tools and insights to assist Retail Health leadership in strategic decision-making through advanced analytics and reporting, while collaborating with cross-functional teams to address business needs.

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