Manager Business Consultant
CVS Pharmacy - Wichita, KS
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Job Description- Works across local market leadership to establish and champion for a local market culture committed to RAF excellence - Acts as the face of Revenue Integrity externally with providers- Identify and execute upon local market RAF strategies - Manage and direct local vendors when appropriate - Conduct data analysis using national tools in conjunction with the corporate lead to identify opportunity areas and paths on track; assure member metrics met - Jointly identify VBCs/non-VBCs to prioritize with RAF initiatives - Engage with clinical team and specific clinics, medical groups, hospitals; attends JOC meetings; supports engagement managers and RN program managers. - Support local market colleagues in ensuring strategic and optimal bids; attends/hosts trainings - Partners closely with segment STARs, MSO, product, sales, network, clinical, and MEU - Partners with Corporate Revenue Integrity program leads to monitor local results and drive high quality performance outcomes- Develops a rapport with providers to act as "best practices" resource on coding practices- Maintains current knowledge of ICD-10 codes, CMS documentation requirements, and state and federal regulations - Identifies barriers utilizing critical thinking skills to identify improvement opportunities, communicate them to the national team, and help facilitate gains in efficiency and appropriate risk score capture. - Leads work groups to develop learning strategies to improve health care delivery performance. - Identifies and recommends opportunities for process improvements at the practice level to improve overall risk adjustment scores and gaps. - Shares best practices in risk adjustment across all sites/regions. - Simultaneously manages multiple, complex projects.Required Qualifications- Extensive knowledge of Medicare risk adjustment- Extensive knowledge of medical documentation and coding- Experience with moderate scale initiatives with moderate degree ofcomplexity.- 5+ years experience with one or more of the following methodologies:management consulting, project consulting, business process consulting,financial strategic analysis, strategic businessplanning, and/or risk management consulting.- Demonstrated relationship management skills at the senior level; capacityto quickly build and maintain credible relationships at varying levels of theorganization simultaneously.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications- Negotiation/influencing skills- Intermediate to advanced presentation skillsEducationBachelor's degree and/or 7 years of experienceBusiness OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
Created: 2024-09-07