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Texas, United States
Remote only
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position Summary
Performs complex medical economic projects (e.g. contract rate modeling)
Accountabilities include identification and completion of key deliverables to ensure all business objectives are met.
Responsible for the development and implementation of key medical economics business efforts e.g.medical cost initiatives, policies/programs, budget and analytical models.
Partners and consults with Network Management to provide medical cost analysis to assess effectiveness of contracted rates, creating and implementing plans to effectively manage medical costs based on analysis or trends.
Develops market specific provider reimbursement schedules
Oversees the production of both standard and ad-hoc reports used for risk assessment analysis, budgeting, and hospital chargemaster analysis and forecasting.
Coordinates rate approvals and develops pricing for most complex contractual arrangements.
Develops and communicates tactical and strategic plans to satisfy information needs across products, segments and markets to a broad audience
Required Qualifications
3+ years demonstrated leadership and/or project management experience
3+ years of healthcare and/or analysis experience.
Preferred Qualifications
• Knowledge of managed care and how provider reimbursement policies relate to the control of medical claims costs.
• Comprehension of provider contracts and the potential impact the regulatory/legislative environment has on reimbursement strategies.
• Understanding of internal and external database applications.
• Knowledge of market-place delivery (understanding of provider relationships).
Skill in:
• Strong communication/presentation skills.
• Strong software and modeling skills.
• Strong analytical ability and familiarity with advanced financial and healthcare concepts.
• Ability to manage conflicting priorities and multiple projects concurrently.
EducationBachelor's Degree or equivalent work experience required
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$46,988.00 - $102,000.00This 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.
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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
