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CVS Health Manager, Medical Economics in Boston, Massachusetts

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

The Medical Economics Unit (MEU) is responsible for identifying and mitigating medical cost trends for the Aetna business unit. We are hiring for a position to assist in the analysis and compliance of the Mental Health Parity and Addiction Equity Act (MHPAEA) regulatory requirements. As a Manager of Medical Economics, you will work closely with compliance, network and other MEU teams to assist with data requests, analytics, documentation and rate setting.

Responsibilities you would manages, lead, or participates in (e.g. Medical Cost Savings Initiatives):

  • Project Management accountabilities include project oversight including initiation, 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 and analytical models.

  • Accountable for all financial projections associated with project.

In this role you will be able to demonstrate:

  • Ability to analyze data and information and summarize findings for a variety of stakeholders.

  • Lead and own all financial projections within the projects

  • Ability to communicate effectively

  • Ability to quickly grasp business concepts, objectives, and strategies and summarize them

  • Proven experience leading cross-functional, matrixed projects and programs

  • Strong attention to detail, organizational skills, and the ability to manage multiple tasks while meeting deadlines

Qualifications:

  • 5-7 years work experience

  • 3 + years experience collaborating across the enterprise business segments to understand business needs and requirements

  • Experience developing and implementing new ideas that support the program work and team, while helping the company achieve compliance with regulatory requirements

  • Experience influencing change to improve processes, organization effectiveness and systems

  • Assist others to identify solutions to issues that negatively impact the program and/or project goals

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.

Education

  • Bachelor's Degree or equivalent work experience required

This is a hybrid role located at a CVS hub or remote

The role does not offer sponsorship

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,300.00 - $159,120.00

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.

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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .

  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 04/21/2025

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.

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