Lead Director, Operational Analytics

This position can be remote or hybrid depending on candidates location to an office* Position Summary The Aetna Healthcare Affordability team is looking for a dynamic leader who has extensive experience providing performance management analytics within clinical and network operations. This position is responsible for producing internal operating metrics on the Healthcare Affordability team with a focus on opportunities, risks, and successes. This position will have to work across business and technical functions to identify needs, solutions and proposals to stand up summary reports to be used by the Healthcare Affordability team. They will forge relationships across the Aetna ecosystem and leverage the entire CVS enterprise where needed to identify data sources and processes to collate information and present in a user-friendly format to support total cost of care initiatives. In this role, you will: Lead the operational reporting efforts on the Healthcare Affordability team Work with the clinical strategists to identify performance metrics of each of their workgroups, identify opportunities and assist in developing performance metrics to gauge the success of their workgroup Produce executive-level summaries of overall performance and opportunities of the HcA team Integrate with the broader Healthcare Affordability team to ensure consistent tracking and reporting of work Support the storytelling and opportunities available for all the Total Cost of Care programs being managed by the HcA team Prepare summary metrics for reporting to senior leaders the opportunities and risks in meeting year-end goals Support ideation for long-term cost of care strategies and analytic needs Comfortable working with Medical and Clinical staff within Aetna CM/UM, Medical Policy, and Clinical Informatics. Works with MEU and other enterprise analytic teams to identify new data, metrics or views needed to support affordability, quality and outcomes improvement initiatives Partner with clinical and medical directors to identify, assess and prioritize potential scorable action items Work across the Aetna business to identify sources of healthcare cost and trend data currently available in all lines of business: Commercial, Medicare and Medicaid Analyzes data, healthcare trends and provides suggested actions from data Work closely with Medical Economics Unit (MEU), Analytical & Behavior Change (A&BC), and other areas that have currently available analytic tools to identify sources of healthcare cost and utilization trend and SAI performance data Develop internal tools, using Power BI, ThoughtSpot or similar solution to bring in high level data points from disparate data sets across Aetna to be used in understanding cost trends and drivers in support of Hotspot and POD ideation teams Work with leaders across business units to identify data sources and solutions available to support total cost of care initiatives Works with finance, data engineering and IT to bring solutions and ideation to completion Supports business unit's ideation and business case strategy with analytic thought leadership, modeling and suggestions Required Qualifications A minimum of 10 years of direct healthcare experience within a large payer organization, with a focus on healthcare analytics, program evaluation, or outcomes measurement Proven track record of developing analytic solutions and operating effectively within a cross-functional, matrixed environment Demonstrated ability to adapt and perform in a dynamic, evolving business landscape Ability to identify performance gaps and translate business needs into actionable analytic solutions Experience in clinical and provider-based analytics, including forecasting, trend analysis, and projections Experience working with claims data, including detailed line-item analysis and payment operations Familiarity with CM (Care Management), UM (Utilization Management), and other clinical operations and provider datasets Solid understanding of clinical workflows, chronic disease management, care management programs, and value-based care (VBC) concepts Excellent written and verbal communication skills, with the ability to translate complex technical findings into clear insights for non-technical stakeholders Prior people management experience, including coaching, development, and training of team members, is preferred Experience with data visualization and analytics tools such as Tableau, ThoughtSpot, or Quickbase is a plus Preferred Qualifications Strong proficiency in SAS and SQL, and/or Microsoft Power BI, with at least 5 years of experience designing and developing Power BI solutions-preferably leveraging clinical operations or provider utilization data. Experience in healthcare or managed care environments Experience partnering with Medical Economics, Behavioral Health, or Population Health teams Familiarity with causal inference and impact evaluation methodologies Experience supporting or implementing value-based care (VBC) models Working knowledge of interoperability concepts and data integration Experience developing analytic solution roadmaps, including identifying risks and opportunities Education Bachelor's Degree preferred or a combination of education and experience. Pay Range The typical pay range for this role is: $100,000.00 - $231,540.00. This 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. This position also includes an award target in the company's equity award program. Benefits This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr