Senior Medical Economics Lead - Value-Based Analytics

CVS Health; Illinois; Hybrid; USD 83,000 - 183,000; Full time

Job summary

CVS Health is seeking a Senior Manager of Medical Economics to analyze medical costs, quality outcomes, and utilization drivers, translating complex claims data into strategic insights for executives and field leadership.

You will develop financial models, project expenditures, design dashboards, and partner with Finance, Clinical, and Data Science to advance value-based care initiatives while ensuring regulatory compliance.

Qualifications

• 7 years of experience in quantitative analysis, healthcare analytics, or medical economics within the healthcare or payer industry.
• Deep subject matter expertise in value-based care, population health, and medical claims data (ICD-10, CPT).
• Advanced proficiency in SQL for complex data extraction, manipulation, and analysis.

Responsibilities

• Develop financial models and forecasts related to healthcare costs and utilization for executive review and strategic planning.
• Project future healthcare expenditures, estimate potential savings, and evaluate the financial impact of various clinical initiatives and interventions.
• Design and maintain comprehensive reports and dashboards to monitor key performance metrics and critical economic drivers.
• Collaborate with cross-functional teams (Finance, Clinical, Data Science) to identify cost-saving opportunities and optimize value-based payment models.
• Evaluate the effectiveness of value-based care initiatives on overall medical cost and quality outcomes to assess clinical and financial ROI.
• Partner with Data Engineering to develop long-term data assets and infrastructure for scalable, advanced analytics enablement.
• Ensure all analyses and reporting adhere to regulatory requirements and industry standards for medical economics.

Skills

Quantitative analysis

Healthcare analytics

Value-based care

SQL

Leadership

Executive communication

Education

Bachelor's degree in STEM/finance/economics

Advanced degree preferred

Tools

Tableau

Power BI

Job description

CVS Health is seeking a Senior Manager of Medical Economics to analyze medical costs, quality outcomes, and utilization drivers, translating complex claims data into strategic insights for executives and field leadership.

You will develop financial models, project expenditures, design dashboards, and partner with Finance, Clinical, and Data Science to advance value-based care initiatives while ensuring regulatory compliance.