Manager, Business Analysis

CVS Health•Hartford, CT

2d•Remote

About The Position

This role will be responsible for developing provider data, credentialing and additional reporting for internal, external, and departmental customers as required by the business and manage relationships and the reporting process from initiation through submission. This position will monitor compliance with requirements as needed by the business; gathering data from multiple sources to create reporting, identify trends, and ensure accuracy and completeness to inform strategic decision making. Manage the direct execution and documentation of the internal provider sanction process, monitor the sanction dashboard, and communicate with stakeholders on sanctioned and terminated providers. Function as a key operational control role, supporting audit readiness, regulatory compliance, and beneficiary protection. Manage projects to ensure on-time completion according to requirements and within expected timeframe of completion and additional assignments as needed by the business.

Requirements

5+ years of data analysis and reporting experience
Adept at problem solving and decision making
Strong attention to detail and documentation accuracy
Demonstrates experience handling sanctions/exclusions, regulatory or internal audits, and/or similar work with high compliance risk
Experience in collaboration and cross functional teamwork
Demonstrates strong verbal and written communication skills, with the ability to clearly articulate complex information to diverse audiences, including leadership and external stakeholders
Track record of execution and delivery (planning, delivering, and supporting) skills
Experience in provider data and provider credentialing
Experience in data warehousing , SQL Queries and PowerBI

Nice To Haves

Certified Analytics Professional (CAP)
QNXT, EPDB and/or PRMS system experience

Responsibilities

Collect, analyze, and present data related to the provider data and credentialing processes.
Interpret data, identify trends, and draw meaningful conclusions.
Execute timely and accurately on the flagging of sanctioned providers to ensure they are removed from directories and claims payments are stopped and/or recovered.
Maintain complete audit trails to support the work completed.
Support updates to SOPs, job aids, and training materials.
Manage multiple reporting projects with varying due dates and levels of priority.
Identify recurring data issues or control gaps and recommend & execute on process improvements.
Assess the impact of adopting new business analysis advances and make recommendations for their implementation.
Assist with evaluating new technology, tools, and systems that can enhance business processes and operations.
Collaborate with cross-functional teams, under minimal supervision, to gather and document business requirements, translate them into technical specifications, and provide recommendations for technology solutions.
Develop skills outside of an existing comfort zone and encourage others to do the same.
Effectively mentor others.
Address conflicts or issues, engaging in difficult conversations with clients, team members and other stakeholders, escalating where appropriate.