Configuration Management Manager

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Remote: can work anywhere in the US. Position Summary: Medicaid Claim Editing Content Management team. Must oversee ongoing content delivery and maintenance across Medicaid claim editing vendors on QNXT, including supporting the Claim Editing Content Management and Claim Editing Provider Disclosure Tools; testing ClaimsXten deployments; managing system enhancements, customizations, and deviations to support ClaimsXten and Cotiviti; and maintenance of each health plan's service code, modifier, svccodemod exception list). Ad hoc project management and support for MPPS claim editing initiatives, including claim analytics and coding reviews for Medicaid health plans, handling coding questions for claims, contracts, benefits, and references files (CPT, ICD 10, Modifiers, ICD 10 Procedure Codes, Revenue Codes, and DRGs) and identify and facilitate resolutions to configuration, processing, and billing issues. In addition, must oversee Medicaid Pre Implementation Testing (QA testing to validate PPM edits are set up correctly prior to being sent to Cotiviti, project implementation and new rule testing (Development, System, SQA, and UAT testing, and testing for implementation of ClaimsXten for all Medicaid health plans). Also responsible for Medicaid PPM QNXT Claim Editing QA Process (Post Implementation Validation via Daily Edit Recommendation Reviews), PPM QNXT Claim Analytics (Monthly Unreconciled, Monthly Discrepancy, and ad hoc claim.