This list contains only the countries for which job offers have been published in the selected language (e.g., in the French version, only job offers written in French are displayed, and in the English version, only those in English).
We'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. Designs enterprise-wide and/or cross-functional solutions to address business problems. This work results in initiatives that significantly impact organizational strategy, enabling the organization to be competitive in the marketplace and effectively serve its customers. Partners with business owners to optimize the achievement of strategic business objectives, to include profitable growth and improved organizational effectiveness.
Job Responsibility
Advises management through strategic business consultation to support the organization's goals and objectives
Develops standard procedures related to researching, collecting, analyzing, and compiling data and information for business consulting department reports
Develops and implements processes for auditing files, reports, and financial records ensuring compliance with relevant laws and regulations
Communicates with top management to lead individuals to develop a high degree of customer service by fielding internal and external inquiries, finding resolutions, or redirecting as appropriate
Communicates strategically internally and externally with clients and senior management regarding the organization's goals and objectives
Counsels the internal and external department point of contact ensuring concise communication with employees, stakeholders, and members of the senior management
Advises management regarding current business trends and best practices preparing analysis for senior management, stakeholders, and clients
Controls all systems for performance appraisals within the business consulting department ensuring compliance and continuous improvement
Evaluates performance through regular, timely feedback to ensure delivery of exceptional services and engagement, motivation, and team development
Requirements
10+ years work experience in Healthcare Insurance Operations
Mastery of problem solving and decision making skills
Mastery of collaboration and teamwork
Mastery of execution and delivery (planning, delivering, and supporting) skills
Strong SQL Development Skills, Report Development Skills in Power BI and Tableau
Ability to bridge communication gaps between business and IT partners
4 year degree or equivalent business experience
Nice to have
WEDI X12/837I/837P EDI Gateway Processing, Editing and Mapping
Clean Claim Edits
Medicaid Risk Adjustment Strategy
Process Flow and Project Management
What we offer
medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
bonus, commission or short-term incentive program
award target in the company's equity award program