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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 Manager will report directly to the Plan CFO and have oversight to revenue and medical cost initiatives, special projects and many state department interactions. Finance representative on several workgroups and meetings for the Plan. In addition, this individual is responsible for the completion of a variety of external state reporting requirements.
Responsibilities will include:
Coordinate the preparation and completion of a variety of complex state/regulatory reporting requirements.
Identify, implement, monitor, and track effective revenue and medical cost analysis through coordination with medical directors, network management, actuary, medical economics, enrollment, encounter team, etc. This includes oversight of plan initiated medical expense reviews and cost savings initiatives. •
Lead financial analysis and recommendations in support of management's evaluation of strategic, business and growth initiatives, including provider/hospital contracting
Oversight to the premium reconciliation process internally and externally in order to maximize revenue, including risk pools.
Oversight to contractual settlement calculations with hospitals and varying other provider entities.
Oversight to large claims reserves Oversight to reporting financial data by date of service (tied to GAAP financial statements), including quarterly reporting to the state.
Serve as team lead providing guidance and training to less experienced staff members, including setting objectives for the team.
Participate in or lead cross functional workgroups, provider/hospital joint operating committees and ongoing committee meetings (whether within the business unit, within the health plan or with the state agency), in order to implement process improvements, new products or provide guidance on financial impacts.
Adhoc query requests as related to financial data.
Required Qualifications
7-10 years experience
2+ years experience leading a team
Healthcare experience
Building queries in SQL
Education
Bachelor's degree
**This is a fully remote role in the US**
Pay Range
The typical pay range for this role is:
$67,900.00 - $149,328.00
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. 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
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.