Manager, Medical Economics

Position Summary

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, join us to simplify health care one person, one family and one community at a time. The Medical Economics Manager Auditor supports the Charger Master team and Provider Network functions by performing audits related to provider contracts, Facility Charge Master reporting, financial arrangements, and operational compliance.

• Perform audits of provider‑related data and financial arrangements to validate compliance with contract terms, internal policies, and regulatory requirements.
• Review and assess documentation, calculations, data sources, and system outputs related to Medical Economics processes.
• Identify audit exceptions, root causes, and risk levels; support findings with clear evidence.
• Apply defined audit criteria, scoring methodologies, and sampling approaches consistently across audits.

• Serve as primary audit point of contact for provider groups, delegated vendors, and network partners.
• Communicate audit scope, findings, and remediation expectations clearly and professionally to external providers and internal teams.
• Participate in audit discussions involving sensitive financial or operational impacts, maintaining professionalism and objectivity.

• Document audit results, findings, and remediation actions in audit tools, trackers, and work papers.
• Track findings through remediation and verification, escalating risks and delays as needed.
• Contribute to audit summaries, trend reporting, and leadership‑ready materials that support ongoing network quality improvement.

• 5+ years of audit experience in healthcare, payer operations, provider networks, or vendor management.
• Bachelor’s degree or equivalent experience in healthcare administration, finance, business, economics, or related field.
• Ability to analyze data, documents, and calculations to identify discrepancies and assess financial or compliance impact.
• Demonstrated ability to engage external partners via clear written and verbal communication.
• Ability to manage multiple audits or work streams while meeting deadlines.

• Experience supporting Medical Economics, provider contracting, provider data, charge master, or network operations.
• Familiarity with provider audit processes, data integrity reviews, or quality programs.
• Experience documenting audit results in structured tools (Excel‑based audit tools, trackers, or reporting systems).
• Comfort working cross‑functionally with Network Management, hospitals, and ancillary facilities.
• Advanced Excel skills (audit tracking, documentation, and reporting).

Remote role. Sponsorship is not supported at this time.

Typical pay range: $54,300 – $145,860 per year, based on experience, education, geography, and other factors. Eligible for bonus, commission, or short‑term incentive programs.

Full‑time position eligible for a comprehensive benefits package, including medical, dental, vision coverage; paid time off; retirement savings options; wellness programs; and other resources.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.