Provider Data Services Administrator

CVS Health
1d$19 - $42

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Provides operational support and performs data maintenance and clean-up for data transactions (basic to complex). In addition, performs more complex data transactions and maintenance associated with projects, expansions, and new product implementations. Works with other departments to ensure quality provider data to our members. Acts in Lead role within the Team.

Requirements

  • Provider Data Services background (3-5 years)
  • Demonstrated ability to handle multiple assignments
  • Demonstrated ability to facilitate meetings and make accurate records.
  • Proficient in Microsoft Office Applications with Advanced skills in Excel.
  • Demonstrated success prioritizing work and the ability to multi-task in a fast-paced environment.
  • Demonstrated success in collaborating with others to meet/exceed expectations.
  • Experience providing clear and concise written and verbal communications.

Nice To Haves

  • At least 3 to 5 years EPDB experience.
  • SCM Provider Tab maintenance experience
  • Demonstrated ability to utilize analytical and independent thinking skills.

Responsibilities

  • Maintains and updates provider demographic and contract information, including contractually sensitive or complex transactions, in appropriate systems in support of claims adjudication and provider directory.
  • Works collaboratively with internal/external constituents to implement new networks and complex contractual arrangements.
  • Will provide technical and/or functional leadership within unit (i.e., team lead).
  • Performs validation of system enhancements.
  • Identifies, researches, and conducts root cause analyses (e.g. problem providers identified by PST, trends from routine PDS audits) and collaborates cross-functionally within the organization to recommend process improvements.
  • Conducts and manages audits of provider information and escalates issues for resolution as appropriate

Benefits

  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
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