Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

The Senior Analyst – Business Analytics will be a detail-oriented individual with strong data analysis and analytical skills who is able to work both independently and within a team. Responsibilities include review of state regulations, review of compliance interpretation, writing business specifications, data quality review, data preparation and compliance to regulatory requirements.

Proficiency in all Microsoft Office software applications is required. Desired proficiencies and experience include: Audit Command Language (ACL), or SQL; technical capabilities relative to data mining & report generation; knowledge of claim processing, claim quality audit program, patient management, and/or a working understanding of Aetna products. The candidate will have excellent project management skills and will meet deadlines, balance multiple priorities and demonstrate flexibility. The candidate should exhibit the ability to quickly and positively adapt to a changing environment. It is essential that the candidate builds and maintains effective working relationships with peers, management and others within and across organizational lines. Also desired is demonstrated critical thinking and the ability to articulate ideas clearly and concisely, both orally and in writing. We value a desire and willingness to learn. Finally, the candidate will embrace compliance as a core competency.

Some overtime will be required. The position is open for full-time telework.

Responsibilities:

• Proactively defines, identifies, develops and creates data responsive to regulatory requirements. Including but not limited to the following:

• Perform analytical work requiring ability to capture, analyze and interpret claims data

• Manage translation of business needs into business requirements

• Create complex queries; perform technical programming

• Proactively define, identify, develop and implements data reports responsive to regulatory requests and requirements

• Present data in clear organized format

• Support regulatory data requests related to Health Care Reform

• Creatively translate information using business knowledge and identify additional information needed to support analytical objectives

• Continuous monitoring of key day quality functions within data quality reports and trending month over month to identify problematic issues before release of data

• Recognizes abnormalities through the Data Quality report review and drill down process and explain those to the project team and understand the impact of any abnormalities across RDM and implements solutions

• Leads or acts as a business technical expert in the design of new applications or enhancements including integration of solutions

• May assign work/deadlines to other team members

Required Qualifications

• 1+ month of data interpretation and analysis experience

Preferred Qualifications

• Experience with databases as well interpretation and manipulation of related data

• Healthcare background – ability to review and interpret State/Federal regulations/legislation and create business requirements

• Experience in project management and process redesign

• Strong organizational skills

• Ability to manage multiple projects, tasks and deliverables simultaneously, reprioritizing as needed

• Knowledge of all types of health care products including HMO, PPO, Medicare Advantage and Medicare Part D

• Knowledge of all types of pharmacy products including specialty drug, Medicare Part D and understanding of PBM operations

• Working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook, SharePoint) and Chrome

• Excellent verbal and written communication skills

Education

Bachelors Degree or equivalent experience

Pay Range

The typical pay range for this role is:

$43,700.00 – $107,200.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 07/11/2024

Apply