Manager, Health Policy Analytics & Insights

CVS Health; Alabama; Hybrid; USD 54,000 - 146,000; Full time

Benefits offered by this job

Health insurance

Retirement savings options

Paid time off

Wellness programs

Bonus eligibility

Job summary

CVS Health is seeking a Manager, Medical Policy Business Analytics to lead analytics, reporting, and operational intelligence for Medical Policy and Payment Integrity. You will translate healthcare data into actionable insights, develop dashboards, and monitor KPIs, partnering with Clinical Operations, Medical Policy, Payment Integrity, Technology, Finance, Compliance, and Quality.

This role emphasizes data-driven decision making and timely deliverables aligned with business priorities.

Qualifications

• Minimum 5 years of experience in healthcare analytics, business intelligence, medical policy, payment integrity, healthcare operations, or related healthcare functions.
• Minimum 2 years of experience leading or coordinating projects, analytical workstreams, reporting initiatives, or cross-functional business activities.
• Advanced analytical, quantitative, and problem-solving skills leveraging AI.
• Experience developing executive dashboards, scorecards, KPIs, and performance reporting.
• Experience performing trend analysis, forecasting, root cause analysis, and performance measurement.

Responsibilities

• Manage the development and maintenance of performance reporting for Medical Policy, Payment Integrity, and related operational programs.
• Develop, maintain, and monitor scorecards, KPIs, and trend analyses.
• Analyze policy performance, utilization patterns, coding trends, financial outcomes, and operational effectiveness.
• Identify opportunities to improve affordability, quality, and operational efficiency through data-driven insights.
• Prepare clear summaries, dashboards, and presentation materials for leadership review.
• Oversee the design, development, automation, and maintenance of dashboards, scorecards, and analytical reporting solutions.
• Provide subject matter input on reporting and business intelligence tools and support consistent use of reporting standards.
• Partner with data management and technology teams to improve data accessibility and reporting capabilities.
• Support delivery of accurate, timely, and actionable reporting for business partners and leadership stakeholders.
• Promote self-service analytics and reporting capabilities where appropriate.
• Monitor policy adherence, implementation effectiveness, and compliance with internal controls and regulatory requirements.
• Support policy governance committees through reporting, trend analysis, and metric development.
• Partner with Quality Assurance and Compliance teams to identify and mitigate operational risks.
• Support internal audits, regulatory reviews, corrective action plans, and remediation efforts.

Skills

Analytical thinking

Stakeholder management

Communication skills

AI capabilities

Education

Bachelor's degree or equivalent

Tools

Power BI

Tableau

SQL

SAS

Snowflake

Azure Analytics

Job description

CVS Health is seeking a Manager, Medical Policy Business Analytics to lead analytics, reporting, and operational intelligence for Medical Policy and Payment Integrity. You will translate healthcare data into actionable insights, develop dashboards, and monitor KPIs, partnering with Clinical Operations, Medical Policy, Payment Integrity, Technology, Finance, Compliance, and Quality.

This role emphasizes data-driven decision making and timely deliverables aligned with business priorities.