CVS Health logo
CVS Health

Bringing our heart to every moment of your health.

Senior Manager, Claims Technical Analyst, Medicaid Intake Operations

Support EngineerSupport EngineerFull TimeRemoteSeniorTeam 10,001+Since 1963H1B No SponsorCompany SiteLinkedIn

Location

Arizona

Posted

20 days ago

Salary

$75.4K - $166.0K / year

Seniority

Senior

Bachelor Degree5 yrs expEnglishSQL

Job Description

• Serve as the Technical Subject Matter Expert (SME) for intake rules and matching logic • Liaise with providers and internal teams to resolve questions about EDI and Claims Intake rejections • Provide second-level expert support for intake claim rejections • Analyze large datasets for research and troubleshooting • Collaborate with Product Owners and IT teams on system enhancements and fixes • Participate in testing and verification of business rules and validations • Manage multiple projects and tasks simultaneously while maintaining high-quality results • Support Product Owners, Business Owners, and Leads using technical and analytical expertise • Communicate effectively across all levels of the organization, including cross-functional teams • Write complex SQL queries to join multiple data sources and analyze data for root causes, trends, and opportunities • Analyze EDI and Claims intake rejections from internal and external inquiries, including provider calls • Track and execute solutions for identified issues • Perform User Acceptance Testing for logic changes and enhancements • Develop utilities, queries, and processes for post-production checkout of business rules and system fixes

Job Requirements

  • 5+ years of experience as a SQL Server power user (coding and developing data extracts)
  • 5+ years of data interpretation and analysis experience
  • 5+ years querying large datasets using SQL, SAS, or other data tools
  • Strong documentation skills; writing readable and reproducible code
  • Process improvement mindset; strives to simplify complex processes
  • Proficient in Word, PowerPoint, Excel
  • Experience working independently and prioritizing multiple deliverables
  • Experience managing conflicting priorities and concurrent projects
  • Excellent verbal and written communication skills with experience communicating technical information to non-technical audiences

Benefits

  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost wellness screenings
  • Tobacco cessation and weight management programs
  • Confidential counseling
  • Financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

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