We are seeking a detail-oriented organized individual to join the Individual and Family Plans (IFP) Informatics team. This role will provide analytical support to IFP and market leadership to ensure the accuracy reporting and maximize the opportunities of Risk Adjustment programs at CVS/Aetna.

Leads the analytic solutions and reporting to key stakeholders across ACA program and market leaders. Interact and collaborate with ACA submission, vendor management, compliance, and actuary team to track ACA Risk Adjustment score trend and intervention program results. Act as analytic team lead to ensure timely delivery of key projects supporting VBC performance initiatives.

• Working knowledge of applying HHS ACA Risk Adjustment Methodology, Adult/Child/Infant model, HCC Hierarchy.
• Performs analytics through querying medical, Rx, lab claims to identify high risk gap members.
• Collaborate with Actuary teams to track market/HIOS level risk score trends. Provide forecast and Wakely data comparison to market leaders
• Experience in prospective and retrospective intervention programs, working knowledge of Care Management program and how to close documentation gaps.
• Familiar with HHS RADV program and provide analytical support for RADV audits
• Familiar with membership attribution, VBC provider arrangements and facilitate VBC performance analytics.
• Research and provide analytical insights to optimize intervention programs performance.
• Conduct Revenue Cycle Analysis on intervention programs. Working with Actuary team to generate revenue reports to leadership team
• Develop visualization dashboards and meet with business clients regularly to communicate, drive and create actionable impacts

Pay Range
The typical pay range for this role is:
Minimum: 60,300
Maximum: 130,000

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.

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

jobs.CVSHealth.com/benefits

Required Qualifications

• 5+ years of data manipulation/analysis experience (can include internships)
• 2+ years of experience with SAS, SQL Server and other DB language

Preferred Qualifications
Experience with Exchange/Medicare/Medicaid Risk Adjustment a plus
Experience with Tableau or other data visualization tools preferred
Excellent verbal and written communication skills

Education
Bachelor's degree or equivalent work experience

Business Overview
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. 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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. 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.