Manager, Payer Insights & Analytics Job at CVS Health (Woonsocket)

Value and Access Insights Manager

The Value and Access Manager is responsible for analytics relating to managed ca...

Location

India , Hyderabad

Salary:

Not provided

Amgen

Expiration Date

Until further notice

Requirements

Master’s degree in computer science, statistics or STEM majors with a minimum of 5 years of Information Systems experience
Bachelor’s degree in computer science, statistics or STEM majors with a minimum of 7 years of Information Systems experience
Experience with new product / indication launch especially in respiratory disease area
Working experience on Analytics of products with Medical benefit and Pharmacy benefit usage
Prior experience in contracts and pricing, direct payer experience or value marketing and have a good foundational understanding of the US payer environment and a strong foundation in the U.S. healthcare market
Excellent conceptual problem-solving skills with demonstrated ability to bring structure to vaguely defined problems, pragmatic problem-solving approach, and manage execution
Exceptional written/oral communication skills and executive presence across functions and across different levels of leadership
Authoritative command of complexity and ambiguity
ability to see the big picture
ability to collect, digest and assemble information to enable relevant business analyses

Job Responsibility

Partner with and Patient access and Reimbursement and Brand Marketing teams to build and prioritize analytics and insights plan in support of value and access strategy for Amgen brands
Understand pharmaceutical ecosystem and data sets including medial and pharmacy claims (ex. IQVIA LAAD, Symphony Claims), prescription (ex. IQVIA NPA), outlet (ex. IQVIA DDD)
Provide in-depth, expertise-based oversight and delivery of managed markets analysis including product formulary position, utilization management controls, customer segmentation and control/sophistication assessment
Prepare, continuously refine and present periodic reports tracking product and portfolio performance against business objectives
Execute analytics plan to support payer insights from various payer datasets based on detailed understanding of related datasets i.e Patient level claims data
Payer claims data
Formulary coverage
Specialty Pharmacy Data
Oversee efforts of 1-3 associates, including setting performance standards, managing their staffing, and monitoring performance
Build and maintain strong relationships with cross functional partners

Revenue Analytics Manager

This job description indicates the general nature and level of work expected of ...

Location

United States , Charlotte

Salary:

51.05 - 76.60 USD / Hour

Advocate Aurora Health

Expiration Date

Until further notice

Requirements

Bachelor's Degree in Finance, or Bachelor's Degree in Accounting or related field
Typically requires 7 years of experience in healthcare financial or data analysis
Highly analytical and possess a strong grasp of revenue and finance concepts such as cost accounting, payor contract management, data analyses and scenario analysis
Knowledge of government reimbursement and managed care contracting, including the terms and conditions of payer contracts and their impact on the revenue cycle and operations
Ability to effectively manage a complex, dynamically changing schedule around the needs of customers in providing exceptional customer service to network clients
Ability to communicate and collaborate effectively with all levels of employees, management, executives, and other organizations and to address difficult issues
Ability to work and function in a complex corporate system environment
Works effectively in a team environment and be a supportive contributor or leader in team matters
Ability to work independently and with minimal supervision
Proficiency using Microsoft Office (Word, Excel, Access and Powerpoint), or similar products

Job Responsibility

Performs financial analyses related to the change in volume and pricing impact and support the development of payer strategy and discussions on managed care contracting innovation, future directions and the needed coordination between acute care, ambulatory and Physician groups
Synthesize analyses, deliver key insights and recommendations
Collaborates cross-functionally with key members of Accounting, Decision Support, Strategic Financial Planning, Advocate Aurora Contracting, Business Development, Reimbursement, Marketing, Advocate Medical Group and Aurora Medical Group to identify revenue gaps and yield improvement opportunities
Partners with internal and external resources to determine key revenue strategies, analyze revenue initiatives and identify, share, and implement “best practices”
Assist in determining, coordinating and communicating Advocate Aurora’s pricing strategy directly with business leaders
Directs research, review and assimilation of industry and competitive data to maintain an effective revenue optimizing strategy in the marketplace
Continually evaluates, identifies and implements opportunities for revenue optimization through leveraging integrated system solutions
Assist and monitor the contract load process for various Advocate Aurora analytical tools

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Opportunity for annual increases based on performance
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions

Fulltime

Revenue Analytics Manager

This job description indicates the general nature and level of work expected of ...

Location

United States , Charlotte

Salary:

51.05 - 76.60 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Bachelor's Degree in Finance, Accounting or related field
Typically requires 7 years of experience in healthcare financial or data analysis
Highly analytical and possess a strong grasp of revenue and finance concepts such as cost accounting, payor contract management, data analyses and scenario analysis
Knowledge of government reimbursement and managed care contracting, including the terms and conditions of payer contracts and their impact on the revenue cycle and operations
Ability to effectively manage a complex, dynamically changing schedule around the needs of customers in providing exceptional customer service to network clients
Ability to communicate and collaborate effectively with all levels of employees, management, executives, and other organizations and to address difficult issues
Ability to work and function in a complex corporate system environment
Works effectively in a team environment and be a supportive contributor or leader in team matters
Ability to work independently and with minimal supervision
Proficiency using Microsoft Office (Word, Excel, Access and Powerpoint), or similar products

Job Responsibility

Performs financial analyses related to the change in volume and pricing impact and support the development of payer strategy and discussions on managed care contracting innovation, future directions and the needed coordination between acute care, ambulatory and Physician groups. Synthesize analyses, deliver key insights and recommendations
Collaborates cross-functionally with key members of Accounting, Decision Support, Strategic Financial Planning, Advocate Aurora Contracting, Business Development, Reimbursement, Marketing, Advocate Medical Group and Aurora Medical Group to identify revenue gaps and yield improvement opportunities
Partners with internal and external resources to determine key revenue strategies, analyze revenue initiatives and identify, share, and implement “best practices”. Processes should be aligned / coordinated through discussions with leadership from Aurora in like areas
Assist in determining, coordinating and communicating Advocate Aurora’s pricing strategy directly with business leaders
Directs research, review and assimilation of industry and competitive data to maintain an effective revenue optimizing strategy in the marketplace
Continually evaluates, identifies and implements opportunities for revenue optimization through leveraging integrated system solutions
Assist and monitor the contract load process for various Advocate Aurora analytical tools

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Opportunity for annual increases based on performance
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions

Fulltime

Global Insights, Senior Manager Rare Disease

Join Amgen’s Mission of Serving Patients. At Amgen, if you feel like you’re part...

Location

United States , Chicago; Thousand Oaks

Salary:

155747.20 - 210716.80 USD / Year

Amgen

Expiration Date

Until further notice

Requirements

Doctorate degree and 2 years of market research, analytics, competitive intelligence, sales and/or marketing operations experience
Master’s degree and 6 years of market research, analytics, competitive intelligence, sales and/or marketing operations experience
Bachelor’s degree and 8 years of market research, analytics, competitive intelligence, sales and/or marketing operations experience
Associate’s degree and 10 years of market research, analytics, competitive intelligence, sales and/or marketing operations experience
High school diploma / GED and 12 years of market research, analytics, competitive intelligence, sales and/or marketing operations experience
Minimum of 2 years experience directly managing people and/or leadership experience leading teams, projects, programs, or directing the allocation of resources

Job Responsibility

Synthesize information from a variety of sources to develop strategic insights that address business needs
Integrate insights and knowledge to develop business cases and facilitate workshops to support clinical development plans, lifecycle management and other strategic decisions
Plan, design, and lead primary market research with a research agency for assets across various phases of the product lifecycle
Lead ad hoc strategic secondary analytics to inform strategic decisions
Be the subject matter expert on HCP, patient, and payer insights for the brand
Clearly communicate insights and recommendations to variety of audiences, including senior leadership
Partner with commercial leadership and cross-functional partners to define and prioritize objectives, budget and work plans
Identify, evaluate, and manage relationships with best-in-class vendors
Support advancement of AI capabilities for insights generation
Support Amgen’s advancement in marketing excellence through aligned insights generation and deep brand-building knowledge

What we offer

Retirement and Savings Plan with generous company contributions
Group medical, dental and vision coverage
Life and disability insurance
Flexible spending accounts
Discretionary annual bonus program
Stock-based long-term incentives
Award-winning time-off plans

Fulltime

Director, Insights and Analytics

The Director, Insights & Analytics will lead the development of Cabaletta’s comm...

Location

United States , Philadelphia

Salary:

Not provided

Cabaletta Bio Inc

Expiration Date

Until further notice

Requirements

Bachelor’s degree in life sciences, business, marketing, or a related field
advanced degree (MBA, PharmD, MS) preferred
8 years of experience in pharmaceutical/biotech insights, analytics, or commercial strategy
Experience in rare disease, immunology, autoimmune disease, or cell therapy strongly preferred
Demonstrated expertise in: Primary market research
Competitive intelligence
Forecasting and market modeling
Strategic analytics
Strong ability to translate complex scientific and market data into strategic insights
Exceptional communication and executive presentation skills

Job Responsibility

Build and operationalize Cabaletta’s insights & analytics function from the ground up, including defining the operating model, selecting tools and vendors, and establishing repeatable processes for insight generation and decision support
Develop and lead Cabaletta’s commercial insights and analytics strategy across priority autoimmune indications
Translate market data, physician insights, and treatment dynamics into actionable recommendations for leadership
Provide decision support to the Chief Business Officer and executive leadership team on portfolio strategy, indication prioritization, and commercialization planning
Design and execute primary market research with key stakeholders including physicians, payers, patients, and advocacy groups
Generate insights on diagnostic pathways, treatment algorithms, unmet needs, and adoption drivers across autoimmune diseases
Partner with clinical and medical teams to ensure commercial insights inform trial design, endpoints, and value propositions
Establish and lead a competitive intelligence capability across autoimmune cell therapy, biologics, and emerging modalities
Monitor scientific, clinical, regulatory, and commercial developments in competing programs
Deliver executive-level competitive insights to inform strategic positioning and launch planning

What we offer

health and retirement
PTO
stock option plans

Senior Manager, Value & Access Insights, PAR

The Value and Access Insights Sr. Manager is responsible for analytics related t...

Location

United States , Thousand Oaks

Salary:

163072.50 - 220627.50 USD / Year

Amgen

Expiration Date

Until further notice

Requirements

Doctorate degree and 2 years of experience with patient analytics and/or patient access and reimbursement experience OR Master’s degree and 4 years of experience with patient analytics and/or patient access and reimbursement experience OR Bachelor’s degree and 6 years of experience with patient analytics and/or patient access and reimbursement experience OR Associate’s degree and 10 years of experience with patient analytics and/or patient access and reimbursement experience OR High school diploma / GED and 12 years of experience with patient analytics and/or patient access and reimbursement experience
5+ years of healthcare experience in the biopharmaceutical industry, health care, and/or strategy consulting with specific experience and expertise in coverage, access and reimbursement drivers impacting the biopharmaceutical industry
Working experience on Analytics of products with Medical benefit and Pharmacy benefit usage
Prior experience in patient analytics, site of care analytics, brand analytics, or value marketing and have a good foundational understanding of the US payer environment and a strong foundation in the U.S. healthcare market
Strong willingness to collaborate and partner with stakeholders and previous experience in a matrix organization
Excellent conceptual problem-solving skills with demonstrated ability to bring structure to vaguely defined problems, pragmatic problem-solving approach, and manage execution
Exceptional written/oral communication skills and executive presence across functions and across different levels of leadership
Authoritative command of complexity and ambiguity
ability to see the big picture
ability to collect, digest and assemble information to enable relevant business analyses

Job Responsibility

Partner with Patient Access and Reimbursement (PAR) team and Brand Marketing teams to build and prioritize analytics in support of PSP strategy
Through detailed reporting, analysis and quarterly business reviews, monitor the current program objectives and provide recommendations to PAR leadership on the optimal design changes
Provide strategic guidance and manage onshore and offshore team members
Understand pharmaceutical ecosystem and data sets including medical and pharmacy claims
Prepare, continuously refine and present periodic reports tracking product and portfolio performance of PSP programs against business objectives and KPIs
Execute analytics plan to generate insights from various internal and external datasets
Build and maintain strong relationships with cross-functional partners
Partner with PAR stakeholders and cross-functional teams in the build-out of the new patient services CRM system
Perform advanced analytics including longitudinal patient level analysis, time series modeling, customer segmentation and diagnostics
Create data analytics models to generate strategic actionable business insights using SQL, Databricks, Python and Microsoft Excel

What we offer

A comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts
A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan
Stock-based long-term incentives
Award-winning time-off plans
Flexible work models where possible

Fulltime

Senior Manager Value & Access Insights

Senior Manager Value & Access Insights at Amgen, US - California - Thousand Oaks...

Location

United States , Thousand Oaks

Salary:

185806.00 - 204764.00 USD / Year

Amgen

Expiration Date

Until further notice

Requirements

Master’s Degree (or foreign equivalent) in Business Analytics, Management of Information Systems, Engineering, Mathematics or related field and 3 years of experience in the job offered or in an analytics-related occupation
Position requires 3 years of experience in the following: 1. Performing Gross-To-Net-based pre-deal contracting analytics for payer and provider segments, including modeling financial impacts through share-shift and NCR strategies using Excel and Anaplan
2. Developing Gross-To-Net forecasting models, including Average Sales Price, Average Manufacturer Price and Best Price related impact analyses using Anaplan-based models
3. Analyzing rebates invoice data, IQVIA payer-level claims data, and invoice discrepancies to measure payer performance and support formulary validation
4. Analyzing chargeback data, IQVIA DDD, and provider reimbursement data to assess contract performance and support Provider contracting and NCR optimization
5. Building supervised and unsupervised predictive models using Python to create price elasticity predictors that help identify provider sensitivity for provider contracting strategies
6. Conducting analytics using IQVIA LAAD, medical claims, and Managed Markets Insight & Technology datasets to evaluate payer coverage, formulary changes, and utilization trends by brand and payer
7. Conducting 340B analytics and provider economics assessments, including purchasing behavior, reimbursement patterns, and site-of-care dynamics
8. Perform patient-level analytics to assess initiation, adherence, abandonment, out-of-pocket exposure, and affordability barriers using IQVIA claims and patient support program data through Copay and Hub data
9. Building dashboards and automated reporting using Power BI and Tableau to synthesize Gross-To-Net, payer, provider insights that support contracting, pricing, payer marketing, market access, and cross-functional commercial strategy across brands and therapeutic areas

Job Responsibility

Partner with account Marketing, Market access and Pricing/Contracting to provide insights around various therapeutic areas like Migraine, Cardiovascular diseases, and Oncology within US healthcare system
Manage a 2–3-member team to deliver actionable insights for the Market access teams as well as the cross-brand initiatives
Responsible for generating, evaluating, and presenting insights and analytics to inform commercial growth opportunities and tactics relating to all aspects of market access
Oversee development of analytical resources for value and access team for Amgen’s Portfolio of existing, launch and pipeline drugs in US healthcare
Assess current data sets and data model to identify and introduce better GTN transparency and analytics
Oversee development of analytical resources for value and access team for Amgen’s Portfolio of existing, launch and pipeline drugs in US healthcare
Oversee efforts of 1-2 staff members, including setting performance standards, managing their staffing, and monitoring performance
Create data analytics models to generate strategic actionable business insights
Produce and deliver regular performance dashboards based on complex data sources
Provide analytics support to field-based market access teams

What we offer

stock
retirement
medical
life and disability insurance
eligibility for an annual bonus or for sales roles, other incentive compensation
health and welfare plans for staff and eligible dependents
financial plans with opportunities to save towards retirement or other goals
work/life balance
career development opportunities
Retirement and Savings Plan with generous company contributions

Fulltime

Manager / Director Business Analytics

We are looking for Job Title: Manager / Director Business Analytics. We are seek...

Location

United States

Salary:

Not provided

SpectraMedix

Expiration Date

Until further notice

Requirements

12+ years of experience in healthcare analytics, management consulting, actuarial consulting, payer strategy, or value-based care environments
Deep knowledge of healthcare economics, payer operations, and value-based care performance drivers
Strong understanding of HEDIS, NCQA, Stars, risk adjustment, utilization management, and provider incentive models
Proven ability to analyze large healthcare datasets including claims, pharmacy, eligibility, provider, and clinical data
Strong financial modeling skills including ROI, PMPM analysis, trend forecasting, and scenario modeling
Experience presenting to executive audiences and influencing senior stakeholders
Demonstrated success leading complex client engagements and delivering measurable outcomes
Experience managing teams, developing talent, and overseeing high-quality work product
Strong technical fluency with SQL, Excel, and BI platforms such as Tableau or Microsoft Power BI
Excellent written and verbal communication skills with strong executive presence

Job Responsibility

Strategic Client Advisory: Serve as a trusted advisor to executive client stakeholders across analytics, network, finance, quality, and value-based care functions
Translate complex performance data into clear strategic recommendations tied to quality improvement, MLR performance, provider engagement, and financial outcomes
Lead executive presentations, steering committees and high-impact client discussions
Identify growth opportunities, operational risks, and emerging market trends affecting client performance
Value-Based Care Leadership: Demonstrated experience navigating the intricacies of VBC contract language (e.g., attribution logic, risk adjustment factors, and benchmark methodology)
Advise clients on value-based care models including pay-for-performance, shared savings, downside risk, capitation, and incentive programs
Interpret HEDIS, NCQA, Stars, risk adjustment, and utilization metrics within the context of provider contracts and health plan economics
Delivery Excellence & Scalable Execution: Establish rigorous standards for data quality, reconciliation, methodology transparency, and audit readiness
Build repeatable reporting frameworks, templates, and scalable processes that improve efficiency and consistency
Identify automation opportunities across recurring reporting, dashboard production, and insight generation

Fulltime

Select Country

Manager, Payer Insights & Analytics

Job Description

Job Responsibility

Requirements

Nice to have

What we offer

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