Provider Education Manager
NunaSalary not specified
Full Time
Senior (5 to 8 years), Expert & Leadership (9+ years)
[Remote] Senior Manager, Provider Claims Diagnostics at CVS Health
Connecticut, United States
Not SpecifiedCompensation
Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Health InsuranceIndustries
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 skills
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
- 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
- Directly support certain strategic Provider Experience initiatives that enable our providers to deliver high quality, accessible, and affordable care for our members
- Work with the local market leadership team to share insights and learnings and stay connected to and translate key risks and wins to other parts of the organization
Skills
Key technologies and capabilities for this role
Questions & Answers
Common questions about this position
Is this position remote or hybrid?
This position can be work at home or hybrid, depending on where the candidate lives.
What is the salary range for this role?
This information is not specified in the job description.
What key skills are required for the Senior Manager role?
The role requires strong project management skills, ability to analyze datasets and trends for process improvements, expertise in provider claims and disputes, and skills in developing presentations and partnering across teams.
What is the company culture like at CVS Health?
CVS Health emphasizes building a world of health with dedicated, purpose-driven colleagues who are passionate about transforming health care in a connected, convenient, and compassionate way.
What makes a strong candidate for this position?
Strong candidates will have experience in provider claims diagnostics, process improvement, project management, data analysis, and partnering with teams, along with the ability to develop executive presentations and serve as a subject matter expert.
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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