Manager, Medical Policy Analytics & Insights
CVS Health
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Benefits offered by this job
Job summary
CVS Health is seeking a Manager, Medical Policy Business Analytics to translate healthcare, claims, policy, and utilization data into actionable insights. You will lead analytics, reporting, performance measurement, and operational intelligence to support Medical Policy and Payment Integrity functions.
The role partners with Clinical Operations, Technology, Finance, Compliance, Quality, and Enterprise Reporting to identify improvement opportunities, monitor KPIs, and deliver data-driven
Qualifications
- 5+ years of experience in healthcare analytics or related healthcare functions.
- Experience developing executive dashboards, scorecards, KPIs, and performance reporting.
- Ability to communicate complex analytical concepts to technical and non-technical audiences.
- Experience driving cross-functional analytical workstreams and stakeholder alignment.
Responsibilities
- Manage development and maintenance of performance reporting for Medical Policy, Payment Integrity, and related 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 dashboards, reporting automation, and BI solutions in collaboration with data teams.
Skills
Education
Tools
Job description
CVS Health is seeking a Manager, Medical Policy Business Analytics to translate healthcare, claims, policy, and utilization data into actionable insights. You will lead analytics, reporting, performance measurement, and operational intelligence to support Medical Policy and Payment Integrity functions.
The role partners with Clinical Operations, Technology, Finance, Compliance, Quality, and Enterprise Reporting to identify improvement opportunities, monitor KPIs, and deliver data-driven
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