[Remote] Provider Data Services Senior Coordinator at CVS Health

Connecticut, United States

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$38,440 – $80,706Compensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Provider Data Services background (1-3 years) or Network background (1-3 years)
Demonstrated ability to handle multiple assignments
High school diploma, G.E.D., or equivalent experience

Responsibilities

Automates and manually loads, maintains, and resolves all new and revised participating provider data transactions (basic to complex) that are contractually sensitive or strategic in nature for Aetna's National Provider business
Maintains and updates provider demographic and contract information, including contractually sensitive or complex transactions, in appropriate systems, in support of claims adjudication and provider directory
Works collaboratively with internal/external constituents to implement new provider and complex contractual arrangements
Directly contacts providers and/or outside vendors to clarify data quality issues
Conducts and manages audits of provider information and escalates issues for resolution as appropriate

Skills

Key technologies and capabilities for this role

Provider Data ServicesNetwork ManagementData LoadingData MaintenanceMS ExcelMS WordAuditsClaims AdjudicationProvider Directory

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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