CVS Health Jobs

CVS Health Sr AnalystWe're building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.

Join us and be part of something bigger helping to simplify health care one person, one family and one community at a time.

Position Summary

The Sr Analyst will join a rental vendor and provider operations team within Network Strategy & Provider Experience and will develop, maintain, and enhance rental vendor and provider relationships including with strategic network vendors and partners including facilities and physicians which serve as contractual networks of care for our members. Serve as the subject matter expert in support of contracting initiatives and data audits to enhance vendor program performance and provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals. Responsible for reviewing, building, and auditing complex contract and network data; may support recruitment efforts and collaborate on negotiations as needed.

- Responsible for reviewing, building, loading, and auditing complex contracts, agreements, amendments and/or fee schedules in contract management systems.

- Conducts research, analysis and/or audits to identify issues and propose solutions to protect data, contract integrity, and performance.

- Manages and performs scheduled program operations reporting and reconciliation activities.

- Provides technical expertise for questions related to contracting and related systems and information contained.

- Partner across the organization to support network development, maintenance, refinement activities, regulatory filings, migration, and rate activities.

- Coordinate program operations activities, lead rental vendor implementation and provider onboarding work stream activities

• Coordinate receipt and processing of provider network data including demographics, reimbursement, contracts, and documentation; may support pre-and post-signature review of contracts and language modification.

- Supports negotiations via handling of system set up within Aetna systems for Commercial programs and contracts.

- Conduct service activities such as provider education, technology usage, or process/policy updates.

- Coordinate data analysis to identify root causes, develop/contact recruitment targets in support of network management expansion initiatives or analyze market data for outreach mailings to desired expansion targets.

Required Qualifications

• 5
• years related provider service experience successfully resolving and responding to provider reimbursement inquiries.
• Advanced user experience in provider data/network setup and maintenance and claims research in core systems (ACAS, PRMS, EPDB, SCM).
• Demonstrated root cause analysis and problem resolution skills.
• Strong meeting facilitation, organizational, and documentation skills.
• Strong communication, critical thinking, and interpersonal skills.
• Advanced Excel and Crystal reporting skills.

Preferred Qualifications

Education

• Associate degree or equivalent combination of education and health care operations experience.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$46,988.$0 - $112,200.00

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.

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing 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.

Additional details about available benefits are provided during the application process and on Benefits Moments.