Lead Director - Medical Economics

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

Oak Street Health is an advanced primary care VBC provider. OSH has risk arrangements with over 20 payers; including all of the large national payers. This role will oversee a team responsible for monthly medical cost trend analytics and collaborative efforts to deliver focused analytical research, complex financial modeling, and business decision support. You will provide oversight of all activities related to medical cost trend analytics, including creating timely data reconciliation and reporting, collaboration with Oak Street leadership and developing creative solutions to drive medical cost improvement.

The ideal candidate brings extensive medical economics knowledge and understanding, expert data mining and outside the box/adaptable thinking and turning data into actionable insights. Strong relationship management skills and a proven ability to lead and motivate high-performing teams are essential. A proactive, self-driven approach and the ability to thrive in a fast-paced, collaborative environment are critical for success. This role offers broad organizational exposure and frequent engagement with senior leaders.
 

Key Responsibilities:

• Establish and maintain productive, complex, high-value initiatives 
• Work collaboratively across executive leadership, population health, and finance to ensure all constituent questions and needs are met on a timely basis
• Assist in developing workflows and strategies to integrate data and reporting effectively.
• Analyze regional and payer specific performance against external benchmarks to identify opportunities for improvement
• Lead team to leverage reporting/data to monitor performance against financial, clinical, cost and efficiency targets
• Perform complex financial assessments to support decision-making and identify areas for improvement and efficiencies.
• Advocate for and drive strategic consultation on actions and tactics to enhance contract performance.

Required Qualifications:

The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company’s business, as well as significant interaction with business leaders. The candidate will be expected to have the following key attributes:

• 10+ years of demonstrated leadership and project management experience
• 8+ years of experience in model development, particularly in value-based care financial models and risk-based arrangements
• Proven medical economics experience along with contract analytics
• Proven leadership and people management skills, with a track record of motivating high-performing teams
• Proven experience w/SQL and Excel
• Proven Health plan knowledge
• Proven knowledge of clinical models, technical attribution logic, as well as medical management concepts
• Proven expertise in complex data collection, modeling & analysis, and turning data into information and influencing business decisions

Preferred Qualifications:

• Prioritize & manage multiple initiatives while managing customer expectations and business priorities
• Excellent communication skills and collaboration with internal & external constituents
• Adept at execution and delivery, with strong planning, delivery, and support skills
• Mastery of problem-solving and decision-making skills, with a growth mindset and commitment to continuous development
• Experience in Value Based Care financial models
• Experience in Risk-Based arrangements and Value-Based Care in Government services
• Advanced skills in Excel and SQL
• Fellow, Society of Actuaries

Education
Bachelors degree in a related field is required.

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. 
 

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: 01/18/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.