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Senior Manager - Medical Economics - Medicaid



Hartford, CT, USA
Posted on Monday, June 10, 2024

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

This role on the NSPE Value Based Analytics team supports Aetna’s Medicaid segment. Join this fast-paced team that works closely together to promote the development and growth of value based contracts across Aetna’s 16 Medicaid plans.

Responsibilities may include: Querying and analysis of complex provider claim, financial and other data to support VBC negotiations/renegotiation and ideation of new VBC arrangements, including complex vendor programs. Creation of ad-hoc reports and analysis including financial performance, ROI analysis, opportunity sizing, etc. Support the administration of established VBCs including financial reconciliation, payment support, provider-facing support such as JOC participation and problem-solving. Management and development of a team of analysts.

Required Qualifications

  • Bachelor's degree or equivalent experience
  • 5+ years prior relevant work experience
  • Seeking a detail oriented individual with superior analytical and problem-solving skills.
  • Strong organizational, management and leadership skills. Ability to handle multiple priorities in a fast-paced environment.
  • Excellent written and verbal communication skills. Must be able to translate complex data to actionable information and communicate to varied audiences including health plan senior leadership, providers and internal business partners.
  • Excellent Excel skills required. Ability to query data (using SAS, SAS EG, SQL or other tool) required.

Preferred Qualifications

  • Prior experience in Medicaid and/or VBC preferred. Knowledge of managed care, provider contracts and provider reimbursement methodologies preferred.
  • Prior experience with QNXT preferred.


  • Bachelor’s degree or equivalent work experience required

Pay Range

The typical pay range for this role is:

$75,400.00 – $174,200.00

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.

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 jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 07/31/2024