Lead Director, Business Consultant

CVS Health•Work At Home-Florida, TX

1d•$100,000 - $231,540

About The Position

Designs enterprise-wide and/or cross-functional solutions to address business problems. This work results in initiatives that significantly impact organizational strategy, enabling the organization to be competitive in the marketplace and effectively serve its customers. Partners with business owners to optimize the achievement of strategic business objectives, to include profitable growth and improved organizational effectiveness.

Requirements

10+ years work experience in Healthcare Insurance Operations
Mastery of problem solving and decision making skills
Mastery of collaboration and teamwork
Mastery of execution and delivery (planning, delivering, and supporting) skills
Strong SQL Development Skills, Report Development Skills in Power BI and Tableau
Ability to bridge communication gaps between business and IT partners.

Nice To Haves

WEDI X12/837I/837P EDI Gateway Processing, Editing and Mapping
Clean Claim Edits
Medicaid Risk Adjustment Strategy Process Flow and Project Management

Responsibilities

Advises management through strategic business consultation to support the organization's goals and objectives.
Develops standard procedures related to researching, collecting, analyzing, and compiling data and information for business consulting department reports.
Develops and implements processes for auditing files, reports, and financial records ensuring compliance with relevant laws and regulations.
Communicates with top management to lead individuals to develop a high degree of customer service by fielding internal and external inquiries, finding resolutions, or redirecting as appropriate.
Communicates strategically internally and externally with clients and senior management regarding the organization's goals and objectives.
Counsels the internal and external department point of contact ensuring concise communication with employees, stakeholders, and members of the senior management.
Advises management regarding current business trends and best practices preparing analysis for senior management, stakeholders, and clients.
Controls all systems for performance appraisals within the business consulting department ensuring compliance and continuous improvement.
Evaluates performance through regular, timely feedback to ensure delivery of exceptional services and engagement, motivation, and team development.