Medicaid State Reporting Analyst

Connecticut, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Health InsuranceIndustries

Requirements

Candidates must have 5+ years of data analytics experience, including 3+ years with healthcare data (enrollment, claims, lab) in a data warehouse environment. Experience with HEDIS or other quality measurement programs is required, along with 3+ years of advanced SQL querying in a large relational database environment and 3+ years of experience creating reports and pivot tables in Excel. The ability to interpret technical specifications and communicate technical concepts is also necessary.

Responsibilities

The Medicaid State Reporting Analyst will perform research and analysis of HEDIS aggregate and member level data, including writing SQL queries to identify trends, draw conclusions, and validate results. Responsibilities include compiling and communicating findings to internal stakeholders, collaborating with the HEDIS Vendor to validate measure run configurations and troubleshoot issues, and performing research to improve measure logic or source data. The analyst will also support stakeholders in generating member detail files and rate templates, and QA measure updates and file layouts pertaining to HEDIS and Medicaid State Reporting.

Skills

HEDIS

Medicaid Reporting

Data Analysis

Relational Databases

Research

NCQA

CMS Medicare Advantage

Medicare Stars

Exchange

Duals

Long-Term Support Services (LTSS)

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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