*Job Description*Are you interested in a WORK FROM HOME position? An opportunity where you can balance priorities in and outside of work while helping people on their path to better health? If so, consider a role at CVS Health, a Fortune 5 company, as a Healthcare Encounter Analyst - Senior. As a Healthcare Encounter Analyst - Senior for claim reconciliation in the State Medicaid Encounters department, you will work exclusively with Pharmacy generated Medicaid encounters. You will be responsible for researching, analyzing and correcting previously submitted, rejected, Medicaid encounters. A self starter with a natural curiosity and a high attention to detail would be well suited for this role, as many potential issues and creative solutions, to those issues, have not been identified yet. This research includes, but is not limited to, examining setups/configurations as well as comparing text files and their contents to identify trends or issues with the integrity of the data within those files. Many innovative solutions are driven from this research and curiosity. You will also be responsible for serving a select group of clients. You will be responsible for maintaining, and in some cases developing, a relationship with key parties on the client side. Part of developing/maintaining a great working relationship with each client will include providing recurring metric reports to keep the client up to date. For the most part, these metrics are produced from SAS and a proprietary version of AS400. Experience with either of these systems or prior exposure to the PBM or Medicaid industry would be advantageous. The ability to think critically and multitask is very valuable in this role. Additionally, you will be an integral part of recurring client meetings. You must be comfortable and adept with clearly communicating technical information (verbal and written) to non technical people and leading conference calls, when needed.As part of our CVS Health team, you will be empowered to make decisions and think outside of the box, as we truly value innovation. Our team has expanded rapidly and will provide room for growth in the future. This is an excellent opportunity to be part of a multi-functional team which treats each other like family.We offer a comprehensive benefits package which includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays.*Required Qualifications*- 1+ years of professional work experience within data analysis.- 2+ years of experience using Excel in a professional or academic setting.*COVID Requirements**COVID-19 Vaccination Requirement*CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.* If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.* If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.*Preferred Qualifications*- 3+ years of professional work experience, preferably in a related field such as data analysis.- Previous Medicaid Encounter experience and/or PBM experience- 3+ years experience with Excel and Access (and have previously built queries) - Bachelor's degree preferred- Must have strong problem solving skills with the ability to work independently - Great communication skills, as the position will involve communicating with clients*Education*High school diploma/GED required.Bachelor's Degree preferred*Business Overview*At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
CVS Health
Arizona
United States
Healthcare - Allied Health
(No Timezone Provided)
*Job Description*Are you interested in a WORK FROM HOME position? An opportunity where you can balance priorities in and outside of work while helping people on their path to better health? If so, consider a role at CVS Health, a Fortune 5 company, as a Healthcare Encounter Analyst - Senior. As a Healthcare Encounter Analyst - Senior for claim reconciliation in the State Medicaid Encounters department, you will work exclusively with Pharmacy generated Medicaid encounters. You will be responsible for researching, analyzing and correcting previously submitted, rejected, Medicaid encounters. A self starter with a natural curiosity and a high attention to detail would be well suited for this role, as many potential issues and creative solutions, to those issues, have not been identified yet. This research includes, but is not limited to, examining setups/configurations as well as comparing text files and their contents to identify trends or issues with the integrity of the data within those files. Many innovative solutions are driven from this research and curiosity. You will also be responsible for serving a select group of clients. You will be responsible for maintaining, and in some cases developing, a relationship with key parties on the client side. Part of developing/maintaining a great working relationship with each client will include providing recurring metric reports to keep the client up to date. For the most part, these metrics are produced from SAS and a proprietary version of AS400. Experience with either of these systems or prior exposure to the PBM or Medicaid industry would be advantageous. The ability to think critically and multitask is very valuable in this role. Additionally, you will be an integral part of recurring client meetings. You must be comfortable and adept with clearly communicating technical information (verbal and written) to non technical people and leading conference calls, when needed.As part of our CVS Health team, you will be empowered to make decisions and think outside of the box, as we truly value innovation. Our team has expanded rapidly and will provide room for growth in the future. This is an excellent opportunity to be part of a multi-functional team which treats each other like family.We offer a comprehensive benefits package which includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays.*Required Qualifications*- 1+ years of professional work experience within data analysis.- 2+ years of experience using Excel in a professional or academic setting.*COVID Requirements**COVID-19 Vaccination Requirement*CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.* If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.* If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.*Preferred Qualifications*- 3+ years of professional work experience, preferably in a related field such as data analysis.- Previous Medicaid Encounter experience and/or PBM experience- 3+ years experience with Excel and Access (and have previously built queries) - Bachelor's degree preferred- Must have strong problem solving skills with the ability to work independently - Great communication skills, as the position will involve communicating with clients*Education*High school diploma/GED required.Bachelor's Degree preferred*Business Overview*At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.