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Medicaid Provider Data Services Administrator
4 months ago
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 SummaryPreferred TX based hybrid possible remote Liaisons with be the main point of contact for the multiple Network Ops and Health Plan they are aligned to within the Medicaid regions. The communication will filter through the designated Liaisons for all scopes within MPOS.Expectations of liaison:• Provides the Market Liaison with visibility into all issues related to the Network Ops and Health Plans they oversee• Issues can be identified and communicated to all impacted areas simultaneously• Documentation may require revision to support new directives, which will be initiated by the Liaison• Opportunity to address any internal performance issues / educational opportunities internally, prior to Network Ops and Health Plan involvement• Contributes to health plan confidence and partnership• Shortens turn-around-time related to issue resolution (not waiting on HP response)• Prevents recurrence of repeated requests to the health plan for the same issue/question• Less impact on productivity• Market liaisons do not currently have a productionLiaisons will handle and support the following:• Attend regular meetings for the State/Health Plan they are assigned to.• Conduct regular meetings with network and/or state health plan team.• Compiling and sharing state specific Inventory reports by state and region for the entire MPOS team• Intaking and reviewing escalated requests for entire MPOS org, ensuring issue resolution, and communicating outcomes in a timely manner. Prioritizing issues as required.• Support and maintain state market rules for all MPOS and communicate changes to all MPOS teams.• Be the SME and POC for provider data clean-up for assigned states• Cascade any issues or trends occurring within their regions and/or states and report those back to MPOS management.• If any state specific requirements are not captured within the PCR and repeated issues occur, the Liaison will be the point of contact for engagement with Network Ops and Health Plan for overall resolution• Any state specific needs for Pends the Pend Lead will work closely with the Liaison to gain accurate data required, while the Liaison takes the lead in identifying root cause and engages Network Ops and Health Plan if needed• Upkeep Market Lead and Manager Teams Q&A Assignment (monthly)Required Qualifications• 6+ months' experience working with provider data.• 1+ years' experience with QuickBase.• 6+ months' experience communicating directly with internal teams and external partners.• Microsoft skills in Word, PowerPoint and Outlook.• Experience with Microsoft Excel. Must be able to do VLOOKUPS and pivot tables.• Problem solving and troubleshooting knowledgePreferred QualificationsProvider data, provider operations, network experienceQNXT system knowledgeSQL experienceEducation• Bachelor degree or equivalent experience. Pay Range The typical pay range for this role is: $18.50 - $35.29 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 We anticipate the application window for this opening will close on: 06/25/2024 We are an equal opportunity and affirmative action employer. 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.
