Senior Analyst Project Management

Job DescriptionActs as an Advocate for, and support, the business by serving as a quality champion through measuring and monitoring the quality and effectiveness of work processes in claim processing and/or customer service that impact customer satisfaction, medical cost management, and operational efficiency. Consult and/or work cross functionally to influence and promote change in order to continually deliver quality service to our internal and external customers.Position Summary/MissionAccountable for review and/or handling of quality audits. Uses analytical and statistical techniques and tools to evaluate and model business processes. Influences enhancements to business processes and system infrastructure to improve quality data. Utilizes quality assurance methodologies to review aspects of the organization. Performs audits including, but not limited to quality management and procedural documentation, in accordance with company policies. Conducts contractually required third party customer audits. Obtains required data from the appropriate source (financial, systems, billing, etc.). Conducts audit and analysis; provides evaluation of findings. Develops and delivers recommendations or findings in a report format suitable to the audience.Pay RangeThe typical pay range for this role is:Minimum: 43,700Maximum: 100,000Please 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- 3-5 years prior claim audit experience - Strong written and verbal communication- Ability to multi task and prioritize duties- Attention to detailPreferred Qualifications- Bachelor's degree- CPC- Wide Healthcare claim experienceEducationDiploma/Associates degreeBusiness 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: 2024-10-19