Payer Integrity Analyst, Revenue Cycle, CVS Health

CVS Health

Location:
United States, Work At Home

Category:
Customer Service

Contract Type:
Employment contract

Salary:

43888.00 - 85068.00 USD / Year

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Job Description:

The Payer Integrity Analyst plays a key role in supporting the implementation, maintenance, and optimization of payer contracts. Working closely with the Lead Contracting Director and cross-functional teams, this role ensures the seamless integration of payer requirements into internal systems and workflows. The Analyst will collaborate with departments such as Revenue Operations, AR, IT, and Clinical Operations to drive contract accuracy, operational efficiency, and payer compliance.

Job Responsibility:

Research, document, and maintain payer-specific requirements for system implementation
Manage and update payer fee schedules for assigned contracts
Support the implementation of new services in collaboration with MinuteClinic operations
Serve as the primary point of contact for assigned payers
Partner with internal teams including Contract Administration, Revenue Cycle Operations, and IT to ensure contract alignment and execution
Build and maintain strong relationships with internal and external stakeholders
Identify and implement process improvements, automation opportunities, and workflow enhancements
Assist in onboarding and training new team members
Contribute to the development of standardized policies, procedures, and training materials
Collaborate with departments such as Credentialing, Billing, Compliance, Legal, Marketing, and Call Center teams to ensure effective contract integration
Support data analysis and reporting to inform business decisions and contract strategies

Requirements:

5+ years of experience in the health insurance industry
Strong knowledge of insurance payers and contract structures (national, regional, or local payers)
Proficiency in Microsoft Excel (Pivot tables, VLOOKUP) and Microsoft Teams
Excellent communication and collaboration skills

Nice to have:

Experience with Epic, AthenaHealth, or similar healthcare systems
Background in health plan contract implementation experience
Familiarity with contract management systems or similar databases
Strong analytical skills with the ability to interpret data and make informed recommendations
Experience developing and delivering presentations to stakeholders

What we offer:

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues 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:
August 05, 2025

Expiration:
August 14, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Payer Integrity Analyst, Revenue Cycle