Configuration Management Manager, CVS Health

CVS Health

Location:
United States, Remote

Category:
IT - Administration

Contract Type:
Employment contract

Salary:

54300.00 - 145860.00 USD / Year

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Job Description:

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.

Job Responsibility:

Oversee ongoing content delivery and maintenance across Medicaid claim editing vendors on QNXT
Support the Claim Editing Content Management and Claim Editing Provider Disclosure Tools
Test ClaimsXten deployments
Manage system enhancements, customizations, and deviations to support ClaimsXten and Cotiviti
Maintenance of each health plan's service code, modifier, svccodemod exception list
Ad hoc project management and support for MPPS claim editing initiatives
Handle coding questions for claims, contracts, benefits, and references files
Identify and facilitate resolutions to configuration, processing, and billing issues
Oversee Medicaid Pre Implementation Testing
Responsible for Medicaid PPM QNXT Claim Editing QA Process
PPM QNXT Claim Analytics

Requirements:

Demonstrated Leadership Skills
Experience with system testing and post go-live validation
Familiarity with clinical and code editing concepts and products (Example: Claim Check, ClaimsXten, Cotiviti PPM & CV)
Extensive knowledge of CPT, HCPCS, ICD-10 coding
Must be willing to work 1-2 Sundays each month for content updates
Ability to prioritize and work in a fast paced, deadline oriented environment
Excellent critical thinking skills
Analytical and creative problem-solving abilities

Nice to have:

Clinical Coding Experience - Content Manager
Claim Processing Medicaid
Working with SQL Application
Experience managing a complex team with diverse skillsets
QNXT Experience
Understanding of claim processing guidelines
Understanding of referral & service authorization requirements and logic
Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation
Data query and analysis skills

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost programs including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
June 11, 2025

Expiration:
June 27, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Configuration Management Manager