[Remote] Senior Manager, Provider Claims Diagnostics at CVS Health

Connecticut, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

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)

Responsibilities

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

Skills

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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