• Sr Mgr, Medicare Business Analytics - FEP

    CVS HealthRichmond, VA 23274

    Job #2811601702

  • Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

    Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

    Position Summary

    The Federal Employee Program (FEP) is one of the largest CVS Health PBM clients. The Medicare Business Analytics - FEP - Sr. Manager provides technical, analytical and business support for the FEP Account team. The role serves as the authority for FEP program data analytics, trend analysis, contractual guaranteed financial metrics, and ad hoc client requests. He/she assists in creating and maintaining daily, weekly and quarterly client reports, supports audits for both internal teams and external agencies and year-round quality assurance testing. As new programs, benefits, processes, and technology are deployed, the Medicare Business Analytics - FEP - Sr. Manager incorporates these into all aspects of the claims quality assurance as well as initiates corrective actions to resolve any issues. The role is engaged across all functions of FEP operations, with particular emphasis on solving complex problems, leading and performing advanced analytics, executive presentations and solution ideation. The Medicare Business Analytics - FEP - Sr. Manager works closely with business partners across the organization to understand the business, solve problems, and present recommendations to FEP leadership. As a part of FEP Account Team, he/she will be responsible for developing and maintaining solutions related to key performance indicators/Service warranties/Performance guarantees. The role develops analytic products, including reports and dashboards. Lastly, the Medicare Business Analytics - FEP - Sr. Manager conducts ad-hoc data analysis for FEP and internal partners.

    This position is instrumental in helping to ensure that contract performance guarantees and financial performance are properly monitored and metrics are visible to leadership and operational teams to ensure compliance and client profitability.

    Required Qualifications

    • 5+ years experience with Med D or EGWP data, Medicaid or Medicare Data preferred

    • 7+ years of overall related experience

    • 5+ years experience with SQL, Python, Tableau, SAS

    • 5+ years experience working with large data sources related to Pharmacy Benefit management and/or Healthcare

    • 5 years of claims experience in healthcare

    Preferred Qualifications

    • 5+ years experience with Med D or EGWP data, Medicaid or Medicare Data preferred

    • Strong analytical skills and ability to use data & analytics to uncover root causes and drive decision-making

    • Ability to effectively communicate and present concepts to management

    • Ability to prioritize task in order to meet challenging deadlines and manage multiple, competing demands

    Education Bachelor's degree or equivalent work experience

    Pay Range

    The typical pay range for this role is

    $67,900.00 - $199,144.80

    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.

    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.

    For more detailed information on available benefits, please visit Benefits | CVS Health (~~~)

    We anticipate the application window for this opening will close on: 02/20/2025

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

    We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.