1,456 Economics jobs in the United States

This is a hybrid opportunity with a work schedule consisting of reporting to our office 3 days per week located at 100 Church Street, NYC.

Duties and Responsibilities

• Leverage leading analytical tools to generate insights that facilitate key decisions by department leadership

• Create accurate reports or insightful and user-friendly dashboards that meet stakeholders needs and lead to business insights

• Identify and monitor cost and utilization trends and the root causes in health plan trend performance, providing recommendations for solutions

• Utilize statistical tools to identify, analyze, and interpret patterns and trends in complex data sets

Minimum Qualifications

• Bachelors degree from an accredited institution or equivalent

• Familiarity with programming languages such as SQL, Python or R

• Experience with data visualization and reporting techniques using tools like Tableau, Power BI, or similar

• Advanced knowledge of MS Office (Excel, PowerPoint, etc.)

• Knowledge of statistical methodologies and tools, including experimentation design

• Demonstrated success analyzing large datasets

• Excellent communication skills, both written and verbal, with the ability to present complex information clearly and concisely.

• Strong problem-solving skills and attention to detail

• Ability to work independently and as part of a team

• Continuous learning mindset

Preferred Qualifications

• Bachelors degree in mathematics, Computer Science, Data Science, Engineering, Business Analytics, or similar field

• Experience in data analytics or consulting, preferably in the healthcare industry

• 1+ years' of working experience with SQL

• 1+ years' of working experience with Python

• Familiarity with the AWS ecosystem, specifically Redshift

• Knowledge of health care industry, systems, business strategies and products

• Collaborate with cross-functional teams and stakeholders to understand business goals and identify analytics requirements

• Deliver high-impact presentations to leadership, showcasing data-driven insights and recommendations

• Use advanced analytical tools and software for data analysis and modeling

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Overview

Summary

The Medical Health Economics Analyst conducts and interprets complex healthcare data analysis, including financial modeling and risk assessment. Supports contract negotiations and evaluates reimbursement structures through detailed analytics. Manages multiple projects, ensuring accuracy and timely completion while recommending improvements and presenting findings to stakeholders.

Responsibilities

• Research and analyzes managed care data from the various financial systems and interface tools.

• Performs analysis of complex and varied healthcare data including financial modeling and risk forecasting.

• Work to identify/implement improvements in quality control/timeliness of reporting.

• Extracts, collects, analyzes and interprets health utilization and financial data of various types.

• Interpret an analyze data from various sources using knowledge of healthcare managed care contracts and healthcare administrative claims data.

• Employs existing complex models and implements them on new projects and/or new contexts and she/he designs new solutions for data and analytic challenges the organization faces.

• Support the negotiations of capitated and other VBA agreements between physicians/hospitals and payers/networks through detailed data analytics.

• Develop financial models and inform VBA negotiations parameters and evaluate possible changes to key terms in existing value-based agreements.

• Identify risk/exposure associated with various reimbursement structures.

• Produce prospective analyses in new venture, products, and service offerings.

• Prepare and effectively present analytics or project results to key stakeholders for review and decision-making.

• Evaluate and understand contract language as it relates to reimbursement methodologies for the full spectrum of app provider types.

• Applies detailed understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10 CPT, CPT, HCPCS II, DRG and revenue codes.

• Demonstrates proficiency with various reimbursement methodologies including Per Diem, DRG, fee schedules, and percent of charge.

• Recommends contractual payment term changes that achieve net revenue targets developed by the Regional Managed Care Directors and Contract negotiators.

• Ad-hoc reporting, management and intelligence related to large claimants, sequestration and healthcare exchange programs.

• Accumulates data in logical format, interprets results, makes recommendations and influences outcomes.

• Prepares well-organized project-specific documentation, that includes at a minimum, analytic methods used, ley decision points and caveats with sufficient detail to support comprehension and replication.

• Leads in the development and review of the annual Managed care net revenue budgets to support the annual budget process.

• Evaluates actual contract performance against expected; analyzes data to distinguish patterns and recognize trends in contract performance.

• Demonstrates independent thinking and creativity in development of contract models, standard reports and ad hoc analyses.

• Manages and completes multiple projects in a fast-paced environment within timeframes outlined in the department policies and as specified by leadership.

• Maintains a high degree of accuracy while using large amounts of data.

Participates in special projects and performs other duties as assigned

Requirements, Preferences and Experience

Generally, requires 3 to 5 years of related experience

Bachelor's degree in Finance, Health Care Administration, Accounting or Health and Informatics or related field is required. Master's Degree in a related field preferred

About Baptist Memorial Health Care

At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry—healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.

At Baptist, We Offer:

• Competitive salaries

• Paid vacation/time off

• Continuing education opportunities

• Generous retirement plan

• Health insurance, including dental and vision

• Sick leave

• Service awards

• Free parking

• Short-term disability

• Life insurance

• Health care and dependent care spending accounts

• Education assistance/continuing education

• Employee referral program

Job Summary:

Position: 20294 - Analyst-Medical Economics

Facility: BMHCC Corporate Office

Department: HS Corporate Finance Admin Corporate

Category: Finance and Accounting

Type: Non Clinical

Work Type: Full Time

Work Schedule: Days

Location: US:TN:Memphis

Located in the Memphis metro area

REQNUMBER: 26815

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**
Are you a data-driven problem solver with a passion for healthcare economics? Join our team as a **Manager, Medical Economics** and play a pivotal role in shaping cost-effective healthcare strategies. You'll work both independently and collaboratively on high-impact projects-like contract rate modeling-that directly influence business decisions and improve patient outcomes.
**What You'll Do**
+ **Lead complex medical economic initiatives** from concept to completion, ensuring alignment with strategic goals.
+ **Drive innovation** in cost management through the development of analytical models, policies, and programs.
+ **Partner with Network Management** to analyze contracted rates and identify actionable insights that optimize provider reimbursement and control medical costs.
+ **Design market-specific provider reimbursement schedules** that reflect local dynamics and strategic priorities.
+ **Deliver high-value reporting** -both standard and ad-hoc-for risk assessment, budgeting, and forecasting, including hospital chargemaster analysis.
+ **Coordinate rate approvals and pricing strategies** for the most complex contractual arrangements.
+ **Communicate strategic insights** across products, segments, and markets to diverse stakeholders, turning data into decisions.
**Required Qualifications**
5+ years demonstrated leadership and/or project management experience
5+ years of healthcare and/or analysis experience.
**Preferred Qualifications**
- Extensive knowledge of managed care and how provider reimbursement policies relate to the control of medical claims costs.
- Full comprehension of provider contracts and the potential impact the regulatory/legislative environment has on reimbursement strategies.
- Understanding of internal and external database applications.
- Knowledge of market-place delivery (understanding of provider relationships).
Skill in:
- Advanced communication/presentation skills.
- Advanced software and modeling skills, e.g. Microsoft Excel and Access, SAS.
- Strong analytical ability and familiarity with advanced financial and healthcare concepts.
- Ability to manage conflicting priorities and multiple projects concurrently.
**Education**
Bachelor's Degree or equivalent work experience required
This is a remote role located in the East or Central USA and is not available for sponsorship at this time.
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$54,300.00 - $159,120.00
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.
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 anticipate the application window for this opening will close on: 09/29/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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 Capitation Center of Excellence (COE) team provides oversight for monthly capitation payment submission and processing, ensuring leadership receives information needed for monthly general ledger locks. Individual will need to collaborate with network, accounting, finance, products/benefit area and other internal business areas. Must be able to isolate and troubleshoot issues post capitation run and share findings across teams and the cap system vendor. Issues such as drivers of change and root cause. Must be comfortable working in high paced environment as capitation payments issued and reporting must keep to a monthly cycle. Individual will be present in meetings with programmers that support the capitation system during troubleshooting discussions. Individual must be able to multi-task and work with urgency during monthly cap runs. Must be able to work with large amounts of data as position requires pulling data and summarizing results using Coginity. Individual will be required to present issues and finding to internal team and at times external providers. Must be able to demonstrate critical thinking ability and see issues, tasks to completion. Individual must be able to work in Excel using pivots, formulas, and lookups.
**Required Qualifications**
3+ years' experience directly related to the duties and responsibilities specified, or an equivalent combination of education and work experience.
Very strong interpersonal, relationship management, writing and presentation skills, Proven project leadership experience, critical thinking and data analysis.
Must have knowledge and strong user of Excel and comfort with MS Office applications.
**Preferred Qualifications**
Strong knowledge of EPDB, SCM, Capitation, ACAS, preferred.
Knowledge of SQL, Excel and comfort with MS Office applications.
**Education**
Bachelor's degree or equivalent experience
This remote role does not provide sponsorship at this time.
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$54,300.00 - $145,860.00
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.
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 anticipate the application window for this opening will close on: 08/25/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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**
Are you a data-driven problem solver with a passion for healthcare economics? Join our team as a **Manager, Medical Economics** and play a pivotal role in shaping cost-effective healthcare strategies. You'll work both independently and collaboratively on high-impact projects-like contract rate modeling-that directly influence business decisions and improve patient outcomes.
**What You'll Do**
+ **Lead complex medical economic initiatives** from concept to completion, ensuring alignment with strategic goals.
+ **Drive innovation** in cost management through the development of analytical models, policies, and programs.
+ **Partner with Network Management** to analyze contracted rates and identify actionable insights that optimize provider reimbursement and control medical costs.
+ **Design market-specific provider reimbursement schedules** that reflect local dynamics and strategic priorities.
+ **Deliver high-value reporting** -both standard and ad-hoc-for risk assessment, budgeting, and forecasting, including hospital chargemaster analysis.
+ **Coordinate rate approvals and pricing strategies** for the most complex contractual arrangements.
+ **Communicate strategic insights** across products, segments, and markets to diverse stakeholders, turning data into decisions.
**Required Qualifications**
5+ years demonstrated leadership and/or project management experience
5+ years of healthcare and/or analysis experience.
**Preferred Qualifications**
- Extensive knowledge of managed care and how provider reimbursement policies relate to the control of medical claims costs.
- Full comprehension of provider contracts and the potential impact the regulatory/legislative environment has on reimbursement strategies.
- Understanding of internal and external database applications.
- Knowledge of market-place delivery (understanding of provider relationships).
Skill in:
- Advanced communication/presentation skills.
- Advanced software and modeling skills, e.g. Microsoft Excel and Access, SAS.
- Strong analytical ability and familiarity with advanced financial and healthcare concepts.
- Ability to manage conflicting priorities and multiple projects concurrently.
**Education**
Bachelor's Degree or equivalent work experience required
This is a remote role located in the East or Central USA and is not available for sponsorship at this time.
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$54,300.00 - $159,120.00
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.
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 anticipate the application window for this opening will close on: 09/29/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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 Capitation Center of Excellence (COE) team provides oversight for monthly capitation payment submission and processing, ensuring leadership receives information needed for monthly general ledger locks. Individual will need to collaborate with network, accounting, finance, products/benefit area and other internal business areas. Must be able to isolate and troubleshoot issues post capitation run and share findings across teams and the cap system vendor. Issues such as drivers of change and root cause. Must be comfortable working in high paced environment as capitation payments issued and reporting must keep to a monthly cycle. Individual will be present in meetings with programmers that support the capitation system during troubleshooting discussions. Individual must be able to multi-task and work with urgency during monthly cap runs. Must be able to work with large amounts of data as position requires pulling data and summarizing results using Coginity. Individual will be required to present issues and finding to internal team and at times external providers. Must be able to demonstrate critical thinking ability and see issues, tasks to completion. Individual must be able to work in Excel using pivots, formulas, and lookups.
**Required Qualifications**
3+ years' experience directly related to the duties and responsibilities specified, or an equivalent combination of education and work experience.
Very strong interpersonal, relationship management, writing and presentation skills, Proven project leadership experience, critical thinking and data analysis.
Must have knowledge and strong user of Excel and comfort with MS Office applications.
**Preferred Qualifications**
Strong knowledge of EPDB, SCM, Capitation, ACAS, preferred.
Knowledge of SQL, Excel and comfort with MS Office applications.
**Education**
Bachelor's degree or equivalent experience
This remote role does not provide sponsorship at this time.
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$54,300.00 - $145,860.00
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.
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 anticipate the application window for this opening will close on: 08/25/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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**
This position is accountable for the strategic alignment, operational success and performance management of Medicare Advantage Value-Based Contracts (VBC), by ensuring that VBC arrangements function successfully and work to improve quality of care while reducing costs. This role will serve as the analytics partner for VBC contracts, working with both internal and external partners, to provide medical cost and outcomes focused analytical research, financial modeling, and business decision support.
+ Understand the terms of the VBC arrangements to answer questions, address issues, and provide analytical support
+ Responsible for establishing and maintaining productive, professional relationships with the most complex/high value initiatives and/or highest risk and revenue generating provider systems, networks and value-based relationships
+ Sets the tone for the VBC relationships for both internal and external partners
+ Educates internal and external parties as needed to ensure compliance with contract terms and expectations
+ Assists with workflow development and strategies to integrate data and reporting
+ Works independently to manage relationships and identify/implement solutions to problems
+ Drives provider performance and partners with local market to ensure pathways to performance against business and team objectives
+ Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets
+ Able to perform complex financial assessments
+ Identifies areas where improvements need to be made
+ Advocates-for and drives strategy consultation on actions/tactics to make those improvements
+ Able to advise/counsel network partners on value-based negotiations, deal terms and best practices
+ May serve as a mentor to team members assisting with onboarding and problem solving
+ May be assigned to represent the business/function on special projects
+ This is an individual contributor role
**Required Qualifications**
The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company's business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes:
+ Bachelor's degree along with 3+ years related experience
+ Prior Healthcare experience
+ Experience with Microsoft Office suite, especially Excel
+ Experience with SQL, working with large and detailed data sets
+ Strong communication skills
+ Strong analytic and time management skills
+ Demonstrates success in collaborating with others to meet/exceed expectations
**Preferred Qualifications**
+ Experience in Medicare Advantage and/or Value Based Contracting
+ Ability to remain flexible with ever changing priorities
+ Strong collaboration skills working across various teams
+ Ability to communicate effectively with all levels
+ Experience with SQL, working with large and detailed data sets
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$60,300.00 - $145,860.00
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.
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 anticipate the application window for this opening will close on: 10/10/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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**
Are you a data-driven problem solver with a passion for healthcare economics? Join our team as a **Manager, Medical Economics** and play a pivotal role in shaping cost-effective healthcare strategies. You'll work both independently and collaboratively on high-impact projects-like contract rate modeling-that directly influence business decisions and improve patient outcomes.
**What You'll Do**
+ **Lead complex medical economic initiatives** from concept to completion, ensuring alignment with strategic goals.
+ **Drive innovation** in cost management through the development of analytical models, policies, and programs.
+ **Partner with Network Management** to analyze contracted rates and identify actionable insights that optimize provider reimbursement and control medical costs.
+ **Design market-specific provider reimbursement schedules** that reflect local dynamics and strategic priorities.
+ **Deliver high-value reporting** -both standard and ad-hoc-for risk assessment, budgeting, and forecasting, including hospital chargemaster analysis.
+ **Coordinate rate approvals and pricing strategies** for the most complex contractual arrangements.
+ **Communicate strategic insights** across products, segments, and markets to diverse stakeholders, turning data into decisions.
**Required Qualifications**
5+ years demonstrated leadership and/or project management experience
5+ years of healthcare and/or analysis experience.
**Preferred Qualifications**
- Extensive knowledge of managed care and how provider reimbursement policies relate to the control of medical claims costs.
- Full comprehension of provider contracts and the potential impact the regulatory/legislative environment has on reimbursement strategies.
- Understanding of internal and external database applications.
- Knowledge of market-place delivery (understanding of provider relationships).
Skill in:
- Advanced communication/presentation skills.
- Advanced software and modeling skills, e.g. Microsoft Excel and Access, SAS.
- Strong analytical ability and familiarity with advanced financial and healthcare concepts.
- Ability to manage conflicting priorities and multiple projects concurrently.
**Education**
Bachelor's Degree or equivalent work experience required
This is a remote role located in the East or Central USA and is not available for sponsorship at this time.
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$54,300.00 - $159,120.00
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.
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 anticipate the application window for this opening will close on: 09/29/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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 Capitation Center of Excellence (COE) team provides oversight for monthly capitation payment submission and processing, ensuring leadership receives information needed for monthly general ledger locks. Individual will need to collaborate with network, accounting, finance, products/benefit area and other internal business areas. Must be able to isolate and troubleshoot issues post capitation run and share findings across teams and the cap system vendor. Issues such as drivers of change and root cause. Must be comfortable working in high paced environment as capitation payments issued and reporting must keep to a monthly cycle. Individual will be present in meetings with programmers that support the capitation system during troubleshooting discussions. Individual must be able to multi-task and work with urgency during monthly cap runs. Must be able to work with large amounts of data as position requires pulling data and summarizing results using Coginity. Individual will be required to present issues and finding to internal team and at times external providers. Must be able to demonstrate critical thinking ability and see issues, tasks to completion. Individual must be able to work in Excel using pivots, formulas, and lookups.
**Required Qualifications**
3+ years' experience directly related to the duties and responsibilities specified, or an equivalent combination of education and work experience.
Very strong interpersonal, relationship management, writing and presentation skills, Proven project leadership experience, critical thinking and data analysis.
Must have knowledge and strong user of Excel and comfort with MS Office applications.
**Preferred Qualifications**
Strong knowledge of EPDB, SCM, Capitation, ACAS, preferred.
Knowledge of SQL, Excel and comfort with MS Office applications.
**Education**
Bachelor's degree or equivalent experience
This remote role does not provide sponsorship at this time.
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$54,300.00 - $145,860.00
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.
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 anticipate the application window for this opening will close on: 08/25/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.