Medical Policy Analytics Leader

CVS Health Corporation; Kansas City (MO); On-site; USD 54,000 - 146,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health Corporation seeks a Manager of Medical Policy Business Analytics to lead analytics, reporting, and performance measurement for Medical Policy and Payment Integrity. The role translates healthcare data into actionable insights to inform decisions, monitor performance, and strengthen compliance readiness.

The position partners with Clinical Operations, Medical Policy, Payment Integrity, Technology, Finance, Compliance, Quality, and Enterprise Reporting teams to identify opportunities,

Qualifications

• 5+ years of experience in healthcare analytics, business intelligence, medical policy, payment integrity, healthcare operations, or related healthcare functions.
• 4+ 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.
• Ability to coordinate analytical work, manage competing priorities, and influence stakeholders across a matrixed environment.

Responsibilities

• Manage analytics and reporting for Medical Policy and Payment Integrity.
• Develop and monitor KPIs, scorecards, and trend analyses.
• Design and maintain dashboards and reporting solutions.
• Ensure data accuracy, timeliness, and governance.
• Support policy governance and compliance initiatives.
• Lead data validation, root cause analysis, and continuous improvement.
• Collaborate with Clinical Ops, Finance, Technology, and Compliance.
• Present insights to leadership and drive data-driven decisions.

Skills

Advanced analytics

Problem solving

Stakeholder mgmt

Communication

Education

Bachelor's Degree or equivalent experience

Tools

Power BI

Tableau

SQL

SAS

Snowflake

Azure Analytics

Job description

CVS Health Corporation seeks a Manager of Medical Policy Business Analytics to lead analytics, reporting, and performance measurement for Medical Policy and Payment Integrity. The role translates healthcare data into actionable insights to inform decisions, monitor performance, and strengthen compliance readiness.

The position partners with Clinical Operations, Medical Policy, Payment Integrity, Technology, Finance, Compliance, Quality, and Enterprise Reporting teams to identify opportunities,