Manager Informatics

Job DescriptionThis position is eligible to work remote, anywhere in the U.S., and is considered an individual contributor role.This position will join the Medicaid Informatics team and provide analytical support to fulfill regulatory reporting requirements, describe the demographic and clinical characteristics of the Medicaid membership, identify members eligible for condition management programs, and evaluate the clinical and financial impact of these programs.Required Qualifications5+ years of experience using tools and programming languages (T-SQL, SAS) to extract, manipulate and analyze large datasets from multiple data sources- Makes recommendations about data collection methods, metrics definition and evaluation methods.- Presents analytic reports to clients and stakeholders- Ability to collaborate with multiple business partners to understand their goals, translate business needs into technical requirements, and act as a consultant in developing solutions- Experience with all phases of design and execution of evaluation studies, including defining the research question, identifying data sources, evaluating data quality, performing descriptive analytics, univariate, and bivariate analyses, and identifying and controlling for the impact of covariates - Emphasizes clear documentation and writes code that is readable and reproducible- Identifies opportunity for process improvement and strives to simplify overly complex processes - Contributes to data warehouse enhancements by investigating opportunities for inclusion of new data sources, identifying, and facilitating correction of data quality issues- Responsible for project commitments to quality and on-time deliverables.- Expertise in data storytelling and preparing data for presentation in Excel and Power Point - Strong communication skills and ability to present findings to both technical and lay audiences- Mentoring other analysts in the teamCOVID RequirementsCOVID-19 Vaccination RequirementCVS 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.Preferred Qualifications- 3+ years of experience working with Medicaid populations and data sources, including eligibility, medical claims, pharmacy claims and encounters- Familiarity with medical and pharmacy claims data, including diagnosis codes (ICD10), pharmacy codes (NDC), and procedure codes (CPT)- 5+ years of experience working with Medicaid populations and data sources, including eligibility, medical claims, pharmacy claims and encounters- Understanding of the defining demographic and clinical characteristics of Medicaid populations, including TANF, CHIP, ABD, Expansion, LTSS and dually eligible Medicaid-Medicare - Subject matter expertise in conditions of interest in the Medicaid population, including substance use disorders, mental health, chronic conditions, disabilities, and dual Medicaid-Medicare eligibility- Familiarity with analytical tools and groupers used to group diagnosis codes into condition categories, classify inpatient stays (MS-DRG, APR-DRG) and define an episode of care (ETG)- Familiarity with propensity score matching and other tools to address bias in observational studies- Experience with code automation (Stored Procedures, Functions, Views, SSIS)- Experience with data visualization (Tableau)EducationBachelor's degree in quantitative field or equivalent work experienceBusiness OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2025-11-01