Provider Data Services Senior Coordinator - Remote

Bring 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.

Position Summary:
At CVS health as a Provider Data Services Senior Coordinator you will provided operational support and performs data maintenance and clean-up for data transactions (basic to complex). In addition, performs more complex data transactions and maintenance associated with projects, expansions, and new product implementations. Works with other departments to ensure quality Provider Data to our members. Acts in Lead role within the Team.

In Addition:

• Maintains and updates provider demographic and contract information, including contractually sensitive or complex transactions, in appropriate systems in support of claims adjudication and provider directory.
• Works collaboratively with internal/external constituents to implement new networks and complex contractual arrangements.
• Will provide technical and/or functional leadership within unit (i.e., team lead). - Performs validation of system enhancements.
• Identifies, researches and conducts root cause analyses (e.g. problem providers identified by PST, trends from routine PDS audits) and collaborates cross-functionally within the organization to recommend process improvements.
• Conducts and manages audits of provider information and escalates issues for resolution as appropriate

What you will do:

• Maintains and updates provider demographic and contract information in appropriate systems to support claims adjudication and provider directories.
• Follows area protocols, standards, and policies to provide effective and timely support.
• Coordinates with internal/external constituents to implement new networks and complex contractual arrangements.
• Communicates directly with providers and/or outside vendors to clarify data quality issues. Manages audits of provider information to escalate issues for resolution as appropriate.
• Manages audits of provider information to escalate issues for resolution as appropriate.
• Takes direction to execute techniques, processes, and responsibilities.

Required Qualifications

• Provider Data Services background (2-4 years)
• Proficient in Microsoft Office Applications with Advanced skills in Excel.
• Demonstrated ability to handle multiple assignments
• Demonstrated ability to facilitate meetings and make accurate records.
• Demonstrated success prioritizing work and the ability to multi-task in a fast paced environment.
• Demonstrated success in collaborating with others to meet/exceed expectations.
• Experience providing clear and concise written and verbal communications.

Preferred Qualifications

• EPDB experience.
• Demonstrated ability to utilize analytical and independent thinking skills.

Education:

• Associate's degree or equivalent work experience

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

CVS 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.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.