Manager, Project Program Management

CVS Health

1d•Hybrid

About The Position

This position is a key member of the Claim Optimization Technical Team and plays a critical role in supporting the Commercial Claim Rework Reporting program, as well as other reporting needs across the Claim Center of Excellence. The role is responsible for preparing and delivering production and ad hoc reporting as well as other data needs to support claim operations for all lines of business. The role involves developing new reports as needed, performing data analysis using multiple system data sources, and transforming complex data into clear, actionable insights that support organizational initiatives. Success in this role requires the ability to effectively manage multiple priorities while maintaining a high level of accuracy and timeliness. Strong communication and collaboration skills are essential, as this individual will partner closely with the Claims organization and supporting teams to identify key data elements, define reporting criteria, and deliver effective, data driven solutions.

Requirements

5+ years of directly related experience
3+ years of healthcare experience
Knowledge of Aetna claim processing platform(s) (ACAS/HRP/QNXT)
Experience with ETL tools such as Alteryx and/or Dataiku
Strong Microsoft Excel skills, including VBA
Data analytics experience with the ability to analyze, transform, and present data into meaningful insights
5-7 years of Service Operations experience
Strong communication skills
Proven track record in meeting milestones
Flexible and adaptable; able to work in ambiguous situations
Ability to communicate effectively with all levels of management
Demonstrates excellent active listening, written and verbal communication skills
Able to work effectively with all levels in the organization
Work style that is collaborative, open-door, thoughtful, accessible and people oriented
Possesses strong engagement and organizational skills; can quickly and effectively translate high-level strategic direction and drive both progress and resolution, absorb feedback and quickly incorporate it into work product and seek collaborative problem-solving resolutions across the governance structure

Nice To Haves

Experience with Microsoft Access
Experience with SQL coding and query development
Intermediate to advanced skills in Power BI for data visualization and reporting
Understanding of claims data and claims processing workflows
5-7 years of experience related to standards, measurements, technology, systems and processes, including project consultation

Responsibilities

Preparing and delivering production and ad hoc reporting
Supporting other reporting needs across the Claim Center of Excellence
Developing new reports as needed
Performing data analysis using multiple system data sources
Transforming complex data into clear, actionable insights that support organizational initiatives
Effectively managing multiple priorities while maintaining a high level of accuracy and timeliness
Partnering closely with the Claims organization and supporting teams to identify key data elements, define reporting criteria, and deliver effective, data driven solutions