Analytics, Director of PBM Product and Member Engagement
Professional Diversity Network
Cumberland, RI 02864, USA
Job Description CVS Health, a Healthcare Innovation company, is recruiting an experienced, enthusiastic, and innovative leader to join our Enterprise Analytics organization focusing on prescription benefit management and specialty pharmacy areas 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 in support of cross-functional set of initiatives influenced by leaders from PBM Product Innovation, Member Engagement Strategy, and Operational Process Improvement to help design, assess, and improve programs and services for PBM members and patients. 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 member-centric services.
The essential roles and responsibilities of the role are to:
- Partner with product innovation and management and member engagement strategy leaders, 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 leaders from the Enterprise Analytics organization and IT 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 on-boarding support and ongoing mentorship.
Required Qualifications - 10-15 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. - Experience with patient segmentation and stratification, personalization of outreach, database marketing, and multivariate and A/B testing concepts and measurement. - 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, as well as the operational considerations in mail order pharmacies and call centers - Extensive hands-on experience with SAS, 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.
Preferred Qualifications - 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
Education 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.
Business Overview It's a new day in health care.
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. As a CVS Health colleague, you'll be at the center of it all.
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. 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. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.
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