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Position Summary

Aetna is recruiting for a Senior Manger on the VBC and Network Analytics team to support VBC partnerships throughout Aetna’s Medicaid segment to deliver on Aetna’s Medicaid VBC strategy. You will partner collaboratively and cross functionally with Network and VBC Development customers as well as health plan staff, multiple business areas and other team members to promote the development, growth and operationalization of value based contracts across Aetna’s 16 Medicaid plans.

Responsibilities may include:  Querying and analysis of complex provider claim, financial and other data to support VBC negotiations/renegotiation and ideation of new VBC arrangements, including complex vendor programs. Creation of reports and analysis including financial performance, ROI analysis, opportunity sizing, etc. Support the administration of established VBCs including setup, financial reconciliation, payment support, provider-facing support such as JOC participation and problem-solving.

Requirements

• Bachelor's degree or equivalent years of experience
• 5+ years of experience in related field
• Seeking a detail-oriented individual with superior analytical and problem-solving skills.
• Strong organizational, management and leadership skills. Ability to quickly react and handle multiple priorities in a fast-paced environment.
• Excellent written and verbal communication skills. Must be able to translate complex data into actionable information and communicate effectively to varied audiences including health plan senior leadership, providers and a multitude of internal business partners.
• Excellent Excel skills required.
• 8+ years of prior relevant work experience required.

Preferred

• Experience querying large data set such as claims data (using SAS, SAS EG, SQL or other tool) it preferred.
• Prior experience in Medicaid and/or VBC preferred. Knowledge of managed care, provider contracts and provider reimbursement methodologies preferred.
• Prior experience with QNXT preferred.

Education

• Bachelor’s degree or equivalent work experience required

Pay Range

The typical pay range for this role is:

$75,400.00 - $182,549.40

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.  This position also includes an award target in the company’s equity award program. 
 
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 Benefits | CVS Health

We anticipate the application window for this opening will close on: 10/04/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.