At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

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 All Payers Claim Database (APCD) 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: All Payer Claims Database (APCD) experience, Audit Command Language (ACL), or SQL; knowledge of claim processing, claim quality audit program, patient management, and/or a working understanding of Aetna products; technical capabilities relative to data mining & report generation; . 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:

• Support regulatory data requests related to All Payer Claims Databases (APCD)

• 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 states and implements solutions

• Proactively defines, identifies, develops and creates data responsive to regulatory requirements.

• Manage translation of business needs into business requirements

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

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

• 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

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

• May assign work/deadlines to others

Required Qualifications

• 3+ years of Data Quality review and identification of abnormalities.

• 3+ years of data interpretation and analysis experience.

• 2+ years of Project Management with ability to manage multiple projects and deliverables.

Preferred Qualifications

• 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.

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

Education

Bachelors Degree required or equivalent years of experience.

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

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