Manager VBC Analytics

We’re building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

At Aetna, a CVS Health company, we are committed to transforming healthcare and improving outcomes for the communities we serve. We are seeking a Manager, Medicaid Value-Based Care (VBC) Analytics to support value-based care partnerships across Aetna's Medicaid business and help advance our Medicaid VBC strategy. In this individual contributor role, you will collaborate with Network, Health Plan, and Value-Based Care Strategy teams, along with a broad range of cross-functional partners, to support the development, implementation, growth, and optimization of value-based provider arrangements.

The ideal candidate combines strong analytical expertise with healthcare business acumen and a passion for driving measurable improvements in quality, cost, and provider performance.

• Analyze complex provider, claims, financial, and operational data to support value-based care negotiations, renewals, and the development of new provider arrangements.
• Develop and maintain SQL queries, reports, dashboards, and analytical models to evaluate financial and operational performance.
• Support the administration and ongoing management of value-based care agreements, including implementation activities, financial reconciliations, performance monitoring, payment support, and issue resolution.
• Partner with cross-functional stakeholders to identify opportunities to improve provider performance, enhance contract effectiveness, and achieve value-based care objectives.
• Translate complex data into meaningful business insights and actionable recommendations for stakeholders and leadership.

• 5+ years of relevant professional experience in healthcare analytics, finance, value-based care, provider contracting, or a related field.
• Strong analytical, critical thinking, and problem-solving skills with exceptional attention to detail.
• Demonstrated ability to manage multiple priorities, adapt quickly to changing business needs, and work effectively in a fast-paced environment.
• Excellent organizational, written, and verbal communication skills.
• Ability to independently drive work streams while collaborating across internal and external stakeholder groups.
• Experience developing and executing SQL queries in environments such as Big Query, SQL Server (SSMS/T-SQL), or similar database platforms.
• Experience converting, optimizing, and validating SQL-based analyses, queries, and stored procedures across cloud-based analytics environments while ensuring data integrity and performance optimization.
• Ability to communicate complex analytical findings to both technical and non-technical audiences, including senior leadership.

• Experience working with large healthcare datasets, including medical and pharmacy claims data.
• Experience analyzing healthcare financial performance, including revenue, reconciliations, utilization, and value-based performance measures.
• Knowledge of Google Cloud Platform (GCP).
• Experience supporting Medicaid managed care, value-based care programs, provider contracting, or alternative payment models.
• Understanding of managed care fundamentals and provider reimbursement methodologies.
• Advanced Microsoft Excel skills, including financial modeling and data analysis.
• Experience developing and presenting strategic…