In this position, you will serve as a Medicare Market Consultant to an assigned geography within the Medicare Performance & Business Enablement department. This position will drive Medicare monthly meetings between Market and Segment leadership as a primary responsibility but will also serve as a Medicare liaison and consultant between Medicare Market Leadership and Medicare Segment Leadership.
Responsibilities will include market strategy/competitive positioning, business consultation, performance management, financial analysis, and participation in the annual CMS Medicare bid process. This role will be a trusted business partner to both local market and Medicare segment senior management and identify/lead process improvement opportunities that impact total Medicare P&L.
This position has work from home flexibility
• Manage business processes but will also actively influence local market performance as well as help to shape and drive the markets' competitive strategies.
• Review both financial and medical economic information
• Communicate focus activities on diagnosis (i.e. unit cost / utilization / provider collab / revenue management).
• Drive execution of pricing commitments, corrective action plans, and continuous improvement
• Follow a metrics based approach that allows the segment to understand measured performance to deliver on strategic objectives, cost containment activities, growth objectives, and new initiatives that identify opportunities for further alignment across the Medicare Advantage market and segment leadership teams.
• Oversee the delivery of pricing commitments on an annual basis working cross functionally across the enterprise and facilitates Medicare financial/operational optimization to enable success of our operating model.
• 5+ years experience in Medicare Advantage ecosystem
• 3+ years Healthcare Finance, Actuarial or Medical Economics
• 3+ years Business Strategy/Consulting
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Master's degree in Finance, Business Administration, Economics, Public Health, or Actuarial Studies
Bachelor's degree or equivalent work experience
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Apply on company website