Senior Manager, Provider Claims Diagnostics, CVS Health

CVS Health

Location:
United States, Hartford

Category:
IT - Administration

Contract Type:
Employment contract

Salary:

67900.00 - 199144.00 USD / Year

Save Job

Apply Position

Job Description:

The Provider Experience, Interoperability, Digital Solutions & Provider Operations organization provides foundational operational / enabling support for provider partners and the Network teams that directly interact with these providers. The Strategic Planning and Support team plays a key role in tracking and monitoring the health of critical business functions, supporting strategic initiatives, and partnering to elevate insights that can positively impact provider experience. The Senior Manager, accounts receivable Diagnostics, will leverage existing & new methodologies to help review, understand, and identify process improvements across key provider journeys including self-service / digital transactions, claims management, dispute resolution, and more.

Job Responsibility:

Invest in targeted reviews of specific datasets / trends to bring visibility to process improvement opportunities, both internal and external
Serve as an internal subject matter expert to provide broader training & awareness regarding emerging learnings to help scale identified improvements
Develop presentations, case studies, timelines, and related material to successfully implement strategy or change initiatives, including executive level presentations
Partner with other teams within the organization to rationalize findings & lessons learned related to provider abrasion and facility/physician claim issues
Help bring 'voice of the provider' into key workflow reviews, workshops, and related planning & prioritization exercises
Partner with local market teams to understand and account for trends impacted by contractual or other market-specific dynamics
Monitor existing internal dashboards such as the Provider Experience and Analytics Tool to assess trends, surface outlier performance, and elevate progress
Leverage strong project management skills to monitor implementation and achieve successful outcomes across multiple projects
Establish contacts in diverse business areas to keep informed of new learnings and impact to Provider Experience

Requirements:

A minimum of 7 years' experience in one or more of the following areas: provider revenue cycle operations / optimization, payer relations, healthcare analytics
Ability to work collaboratively in a cross-functional team environment to solve challenging issues and identify opportunities for improvement
Ability to effectively interact with all levels of management
Demonstrates flexibility to support rapid adjustments to strategy and priorities to meet changing business requirements
Demonstrate a proactive collaborative approach to service delivery and have a strong customer focus
Conveys strong sense of urgency to drive issues to closure
Demonstrated ability to analyze & synthesize quantitative and qualitative data to derive actionable solutions
Experienced presenter with ability to provide different views for different levels (e.g., executive vs. end user)
Strong project management experience
Excellent verbal and written communication skills
Strong organizational skills
Bachelor's degree preferred or a combination of work experience and education

Nice to have:

Prior experience across common claims management tools / resources including Availity provider portal, clearinghouse vendor partners, Electronic Data Interchange (EDI), practice management software, etc.
Prior experience with Provider Network functions / processes and market dynamics
Working knowledge of QNXT, HRP, and ACAS

What we offer:

Affordable medical plan options
401(k) plan including matching company contributions
Employee stock purchase plan
No-cost 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:
November 13, 2025

Expiration:
December 13, 2025

Employment Type:

Fulltime

Work Type:

Remote work

View All Jobs In This Company

Job Link Share:

Senior Manager, Provider Claims Diagnostics