Senior Analyst - Claims Adjudication Patient ...
CVS Pharmacy - Woonsocket, RI
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Job DescriptionCVS Health is on a mission to transform healthcare. With a shared purpose to help people on their path to better health, we are finding new ways to care for our communities, leveraging our brick and mortar footprint of 10,000 stores. At the heart of this strategy are the 180,000+ store colleagues who build unmatched human connections with our customers every day. As we seek to simplify a complex healthcare system for the patients we serve, while delivering disruptive innovation at a rapid pace, thoughtful communications that engage, inspire, and activate our colleagues across multiple channels are increasingly essential. As a Senior Analyst of the Pharmacy Payer Innovations team, you will be responsible for managing patient eligibility data related to third party eligibility solutions and supporting our automated eligibility programs. This role will work collaboratively with internal, external and enterprise stakeholders to resolve patient data discrepancy concerns and communicate accurate and effective solutions. This role is also expected to maintain accurate and up to date patient insurance eligibility for enterprise patients in our retail pharmacy system through partnerships across the enterprise to support our automated systems. The position will proactively identify specific eligibility opportunities through data analysis, suggest and develop process improvements to existing system constraints, and cultivate innovative solutions to improve prescription claim billing. This role requires strong analytical, communication, and collaboration skills with the capability to deep dive into the data and extract meaningful conclusions, while also having the ability to work independently. This role will report to the Manager of the Pharmacy Payer Innovations team.Pay RangeThe typical pay range for this role is:Minimum: 43,700Maximum: 97,400Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications 2+ years of experience with retail pharmacy prescription billing and fulfilment process 2+ years of experience using advanced Excel, PowerPoint skills and other MS Office ApplicationsPreferred Qualifications 2+ years of experience with pharmacy claims adjudication related experience Bachelor's degree or equivalent experienceEducationBachelor's degree or equivalent experienceBusiness OverviewBring your heart to CVS Health Every 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. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Created: 2024-09-07