Senior Analyst, Provider Data Services- Bulk loading

CVS Health

1d • Remote

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. At Aetna Better Health of Texas, we are committed to helping people on their path to better health. By taking a total and connected approach to health, we guide and support our members so they can get more out of life, every day. We are looking for people like you who value excellence, integrity, caring and innovation. As an employee, you’ll join a team dedicated to improving the lives of Texas members. We value diversity and are dedicated to helping you achieve your career goals. Position Summary This position can be Work From Home anywhere in the United States. Preferred TX - Maintains the Provider Data (demographic and contractual) for all network and non-network providers. - Ensures all provider information is accurately recorded and maintained to provide for proper reimbursement and member access (i.e., directory listings). - Develops and maintains standards for database integrity, corrective actions, database alignment, and manages communication processes with other departments regarding database improvements. - Provides support for baseline provider data transactions that cannot be administered automatically through the provider database due to system limitations and/or data integrity issues. - Performs baseline demographic transaction updates in provider system applications in support of claim adjudication and Provider directory. - Performs intake triage and responds to network inquiries, escalates when necessary. - Provides on-going department support in research and analysis essential to resolving concerns/issues raised by providers and other internal/external customers. - Conducts audits of provider information and escalates issues for resolution as appropriate. - Automates and manually loads, maintains, and resolves all new and revised participating provider data transactions (basic to complex).

Requirements

• Demonstrated ability to handle multiple assignments.
• 1-3 years' of Provider Data Services background.
• 1-3 years' Network background.
• Advanced Microsoft Excel skills including knowledge of formulas and VLOOKUPs.
• 1+ years' QNXT experience.

Nice To Haves

• Strong communication skills.
• Ability to trouble shoot technical and data issues
• Ability to assist team members
• Ability to offer process improvement ideas

Responsibilities

• Maintains the Provider Data (demographic and contractual) for all network and non-network providers.
• Ensures all provider information is accurately recorded and maintained to provide for proper reimbursement and member access (i.e., directory listings).
• Develops and maintains standards for database integrity, corrective actions, database alignment, and manages communication processes with other departments regarding database improvements.
• Provides support for baseline provider data transactions that cannot be administered automatically through the provider database due to system limitations and/or data integrity issues.
• Performs baseline demographic transaction updates in provider system applications in support of claim adjudication and Provider directory.
• Performs intake triage and responds to network inquiries, escalates when necessary.
• Provides on-going department support in research and analysis essential to resolving concerns/issues raised by providers and other internal/external customers.
• Conducts audits of provider information and escalates issues for resolution as appropriate.
• Automates and manually loads, maintains, and resolves all new and revised participating provider data transactions (basic to complex).

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees