CVS Health PBM Analytics Director in Northbrook, Illinois
CVS Health, a Healthcare Innovation company, is recruiting an experienced, enthusiastic, and innovative leader to join our Analytics organization focusing on prescription benefit management area of the enterprise. In this important role supporting one of the core functions of our business, you will work closely with multiple business partners, leading a group of analytics professionals, to deliver a range of analytic solutions to help enable data-driven decision-making to influence patient, caregiver, and prescriber experience and outcomes related to CVS Health programs and services. You will focus on analytics understanding the impact of PBM offerings on enterprise KPIs and population health, and you will help identify opportunities for analytics to drive program innovation and improvement. You will develop analytic solutions that include assessment and stratification of patient populations, their needs, and opportunities to improve convenience and cost efficiency of PBM clinical and member-centric services.
The essential roles and responsibilities of the role are to:
• Partner with product innovation, as well as with clinical, operations, digital, and sales and marketing partners to identify existing and evolving business needs which can be effectively solved with a variety of analytic approaches.
• Engage with executive leadership to identify areas where analytics can drive business value, frame business problems into analytic questions, and translate analytics into business value.
• Develop and execute a prioritized analytic strategy to address the business needs and partner with analytic and technical/IT leaders as needed to deliver on the strategy.
• Partner with advanced analytics leaders to envision, define and deliver advanced analytic solutions to drive enhanced utilization management outcomes, such as case volume forecasting, automated outlier detection, predictive modeling based on artificial intelligence and machine learning techniques, population segmentation and risk stratification.
• Deliver analytic solution methodologies and capabilities to enable automated insight generation and reporting, such as identification and closure of data gaps, metrics and measurement methodology development, design and prototyping of self-service reporting and data visualization solutions, and adhoc analytic studies.
• Leverage core pharmacy and medical claims data as well as identify and utilize other data sources (EMR, lab results, clinical data and notes, consumer purchasing data, digital engagement data, etc.) to provide actionable and relevant and timely analytic insight.
• Recruit, lead and develop a staff of Master’s and PhD level analytics professional, defining team and individual goals, managing performance and providing onboarding support and ongoing mentorship.
• 10+ years of progressive experience in the analytics field.
• Excellent ability to establish and maintain collaborative relationships with analytic and non-analytic business partners, including executive leadership, in order to elicit business needs and formulate, propose and refine analytic solutions in order to meet the business needs and to drive efficiency and effectiveness improvements and business value.
• Experience building and leading project teams in a matrix environment.
• Proven team leadership and management experience, with ability to recruit, engage and develop staff with advanced degrees and diverse backgrounds and in different geographic locations, ability to allocate resources based on priority and skill level, strengths, and area of expertise; ability to train and mentor junior colleagues.
• Solid understanding and hands-on experience with a variety of analytic processes and techniques, including health economics outcomes research, population health, measurement methodologies development, hypothesis testing, statistical significance testing, modeling and machine learning.
• Solid understanding and hands-on experience working with large data sources, particularly administrative claims, digital engagement, and clinical program data, focusing on efficient data extraction from large databases, data manipulation, and setting up optimized summary data layers.
• Excellent written and oral communication and data presentation skills, with ability to tailor the communication style to the right audience, from the analytic professionals to the senior business leaders.
• Excellent project management skills with ability to lead and engage in multiple projects and initiatives and appropriately prioritize one's own time as well as that of the direct reports and contributing resources.
• Understanding of the healthcare administration landscape and familiarity with PBM industry and business model, including patient and payer concerns
• Extensive hands-on experience with, SQL, Python, R, Tableau and other data, statistical and data visualization tools and techniques, and ability to understand and adapt emerging analytic tools and solutions into the analytic standard operating procedures.
• Management consulting experience a plus.
• Project management experience a plus.
• Working knowledge of pharmacy benefits utilization management programs and experience in using analytics to drive behavior change
Advanced degree in a related discipline, such as epidemiology, public health, statistics, biostatistics, health economics, pharmacy or related field, or MBA with training in statistics and health services utilization analytics.
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited 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.
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