Manager, Medical Policy Analytics & Reporting

4062 Aetna Resources, LLC; Missouri; Híbrido; USD 54.000 - 146.000; Tempo integral

Benefícios oferecidos por esta vaga

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Resumo da vaga

CVS Health is seeking a Manager, Medical Policy Business Analytics to translate healthcare, claims, policy, utilization data into actionable insights. You will develop dashboards, monitor KPIs, and support governance across Medical Policy and Payment Integrity.

This role partners with Clinical Operations, Finance, Compliance, and IT to deliver data-driven recommendations. The position emphasizes data validation, root cause analysis, and continuous improvement, with a focus on affordability and

Qualificações

• 5+ years of experience in healthcare analytics, business intelligence, medical policy, or related healthcare functions.
• 4+ years of experience leading or coordinating projects, analytical workstreams, reporting initiatives, or cross-functional 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.

Responsabilidades

• Manage development and maintenance of performance reporting for Medical Policy and Payment Integrity.
• Oversee dashboards, scorecards, and reporting solutions; promote self-service analytics.
• Monitor policy adherence and regulatory compliance through reporting and metrics.
• Conduct root cause analyses and drive quality improvements.
• Gather and document reporting requirements and support strategic initiatives.
• Coordinate cross-functional projects and present insights to leadership.
• Ensure data quality and governance across analytics platforms.

Conhecimentos

Healthcare analytics

Business intelligence

Policy & payment integrity

Executive dashboards

KPIs & metrics

Stakeholder management

Advanced Excel

Formação

Bachelor's degree or equivalent experience

Ferramentas

Power BI

Tableau

SQL

SAS

Snowflake

Azure Analytics

Descrição da vaga

CVS Health is seeking a Manager, Medical Policy Business Analytics to translate healthcare, claims, policy, utilization data into actionable insights. You will develop dashboards, monitor KPIs, and support governance across Medical Policy and Payment Integrity.

This role partners with Clinical Operations, Finance, Compliance, and IT to deliver data-driven recommendations. The position emphasizes data validation, root cause analysis, and continuous improvement, with a focus on affordability and