Supervisor, Provider Data Services (Must reside in Arizona)

CVS Health

10d•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. Position Summary The Supervisor, Provider Data Services oversees day‑to‑day provider data maintenance activities supporting Mercy Care Plan operations. This role leads a fast‑paced team responsible for reviewing and submitting provider adds and changes, specifically within the QNXT system. In this capacity, they will be ensuring accuracy, timeliness, and compliance with CMS (Centers for Medicare & Medicaid Services) and AHCCCS (Arizona Health Care Cost Containment System) requirements. Based on new contracts, network expansion, and routine provider updates, the Supervisor ensures provider data integrity across downstream functions, including member directories, claims adjudication, encounter submissions, and regulatory utilization reporting. The role provides operational oversight, coaching, and issue resolution while partnering with internal stakeholders to support business and regulatory needs.

Requirements

1-2 years of experience working in provider data management, including work within a claims management system.
1–2 years of customer service and/or operational support experience.
Must reside in Arizona.
High school diploma or GED.

Nice To Haves

Hands‑on experience working with QNXT provider data.
Medical claims processing experience.
Medical billing knowledge.
Basic SQL experience (1–2 years).
Intermediate Microsoft Excel skills (1–2 years).
Ability to manage multiple assignments accurately and efficiently in a fast‑paced environment.
Strong analytical skills with attention to detail.
Effective written and verbal communication skills.

Responsibilities

Oversees day‑to‑day provider data maintenance activities supporting Mercy Care Plan operations.
Leads a team responsible for reviewing and submitting provider adds and changes within the QNXT system.
Ensures accuracy, timeliness, and compliance with CMS and AHCCCS requirements.
Ensures provider data integrity across downstream functions, including member directories, claims adjudication, encounter submissions, and regulatory utilization reporting.
Provides operational oversight, coaching, and issue resolution.
Partners with internal stakeholders to support business and regulatory needs.