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Position Summary
The Aetna Special Investigations Unit (SIU) Data Analytics team is looking for a data-driven individual that can analyze big data and create a story through data aggregation and reporting. The ideal candidate would have a solid understanding of relational databases, medical and pharmaceutical claim data, experience with query development & data analysis and a desire to learn new things.
Job responsibilities include:
- Oversee and/or assist project team with creating queries & reporting tools
- Creation and timely submission of regulatory reporting related to fraud, waste & abuse activities
- Knowledge of analytics tools to analyze large data sets to identify, analyze and interpret trends in complex data sets
- Create and communicate messages based on data analyses, including preparing easy-to-understand visualizations and other related documents for diverse audiences
- Understand data nuances; improve data quality
- Work with advisers from key functional areas to understand potential project impact on the organization, align project work, and execute activities accordingly
- Develop and participate in presentation and consultation with business partners on data, capabilities and performance results
- Ability to research data discrepancies and validate and identify new data sources to expand reporting opportunities that support FWA initiatives and targets
- Influence change with enhancements to business processes, policies and system infrastructure to improve information quality, availability and access
This is a work-from-home position in the US. Ideal location would support East Coast hours.
Required Qualifications
- 1-2 years of solid understanding and experience interpreting medical & pharmaceutical claim data
- Advanced experience in Excel
- Advanced experience with one or more of the following: SQL (Plus), SAS (plus), Python, Power BI, Tableau
- 3+ years of data interpretation and analysis experience
- 1 to 2 + years of project management experience
- Strong business as well as systems knowledge
- Ability to work in a team environment & independently manage workload/deliverables
Preferred Qualifications
- Experience in healthcare fraud, waste and abuse
- Experience with Medicaid and/or Medicaid healthcare claims data and regulatory reporting
- Knowledge of healthcare claims adjudication
- 2+ years of demonstrated leadership
Education
Bachelor’s degree or equivalent experience
Pay Range
The typical pay range for this role is:
$63,300.00 - $139,200.00 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.
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
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.