SR MANAGER, MEDICAID ACTUARIAL REVENUE INTEGRITY

Company: CVS Health
Location: Hartford
Posted on: October 23, 2024

Job Description:

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.

Increase your chances of an interview by reading the following overview of this role before making an application.
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
Aetna is recruiting a Sr. Manager on the Medicaid Actuarial Growth and Strategy team. This position will be the point person for the Medicaid Actuarial team's involvement with Revenue Integrity, a crucial revenue-generating initiative for the Medicaid Business Unit. This position's responsibilities will include (but are not limited to):

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• Tracking and providing monthly updates to Medicaid Market and Executive leaders on the performance of revenue integrity initiatives.
  
• Reviewing emerging results to identify potential risks and opportunities within revenue integrity initiatives.
  
• Working with other internal teams to ideate on and size new revenue integrity opportunities.
  
• Collaborating with Finance teams to support sizing the impact of risk score and revenue related SAIs.
  
• Continuing to standardize revenue integrity deliverables to create more easily digestible information from data.
  
• Working with Informatics to explain the connection between market risk adjustment updates and risk adjustment updates to capitation rates.
  
  To be successful in this position, you will need an ability to risk-assess complex problems and recommend solutions and communicate effectively with leadership teams. Being able to collaborate effectively with stakeholders across the organization will also be essential to success.
  Required Qualifications
  
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  • 7+ years of actuarial or relatable experience
    
  • ASA or FSA credential
    
    Preferred Qualifications
    
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    • Prior experience in Medicaid, and experience with project management is preferred but not required
      
    • Diverse experiences that demonstrate an ability to learn quickly
      
    • Adaptability and ability to prioritize effectively
      
      Education
      
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      • Bachelor's Degree is required
        
        Pay Range
        The typical pay range for this role is:
        $82,940.00 - $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.
        We anticipate the application window for this opening will close on: 10/29/2024
        Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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Keywords: CVS Health, East Providence , SR MANAGER, MEDICAID ACTUARIAL REVENUE INTEGRITY, Executive , Hartford, Rhode Island