At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
The Payer Insights Manager will be engaged in designing, summarizing, and communicating insights from analyses aimed at improving business function and better serving patients. They will closely collaborate with various teams within the operations organization providing key metrics to guide various projects impacted by claims adjudication. The ideal candidate will be an adept communicator, able to translate nuanced claims data into consumable results and impactful visuals. This person will have significant experience calling and manipulating data using SQL and organizing effective visuals in PowerPoint and in business intelligence platforms such as Power BI.
The Network Operations Manager will report to the Sr Manager of Payer Insights and collaborate with their peers on the analytics team.
Required Qualifications
- Conducting complex adjudication analyses to support identified business needs
- Accessing large claims and operations datasets with SQL and designing summary analytic layers for team and dashboard consumption
- Synthesizes insights into focused presentations – tailors data communications toward varied audiences, both technical and non-technical
- Gathers recurring analyses and designs user-friendly dashboards for business partners
- Collaborates with key internal and external stakeholders to evaluate future analytic needs and requirements
Preferred Qualifications
- Python or other scripting experience a plus
- independent, curious, eager to tackle a wide variety of problems, and able to quickly develop knowledge and understanding of new domains and underlying data sources.
- Familiarity with pharmacy workflow and claims adjudication.
- Experience as a project lead with cross-functional teams to develop innovative analytic approaches leveraging all available internal and external data sources.
- Excellent written and oral communication skills.
- Experience developing, testing, documenting and maintaining standardized outcome metrics meeting diverse business needs.
- Experience developing, implementing, testing, and maintaining methodologies for standardized and repeatable reporting for internal and external audiences.
- Ability to interact with and influence decision-making by non-analytical business audiences.
- Working knowledge of statistical methods and the ability to apply them in appropriate use cases (e.g. predictive analytics)
- Ability to travel up to 5% of the time, as needed, per business needs.
Education
- Bachelor's degree or equivalent relevant work experience is required.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$66,330.00 - $145,860.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 12/20/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Top Skills
What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners.
Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
