CVS Health
Bringing our heart to every moment of your health.
Senior Manager, Claims Technical Analyst, Medicaid Intake Operations
Support EngineerSupport EngineerFull TimeRemoteTeam 10,001+Since 1963H1B No SponsorCompany SiteLinkedIn
Location
Arizona
Posted
10 days ago
Salary
$75.4K - $166.0K / year
Bachelor Degree5 yrs expEnglishSQL
Job Description
• Serve as the Technical Subject Matter Expert (SME) for intake rules and matching logic
• Liaise with providers and internal teams to resolve questions about EDI and Claims Intake rejections
• Provide second-level expert support for intake claim rejections
• Analyze large datasets for research and troubleshooting
• Collaborate with Product Owners and IT teams on system enhancements and fixes
• Participate in testing and verification of business rules and validations
• Manage multiple projects and tasks simultaneously while maintaining high-quality results
• Support Product Owners, Business Owners, and Leads using technical and analytical expertise
• Communicate effectively across all levels of the organization, including cross-functional teams
• Write complex SQL queries to join multiple data sources and analyze data for root causes, trends, and opportunities
• Analyze EDI and Claims intake rejections from internal and external inquiries, including provider calls
• Track and execute solutions for identified issues
• Perform User Acceptance Testing for logic changes and enhancements
• Develop utilities, queries, and processes for post-production checkout of business rules and system fixes
Job Requirements
- 5+ years of experience as a SQL Server power user (coding and developing data extracts)
- 5+ years of data interpretation and analysis experience
- 5+ years querying large datasets using SQL, SAS, or other data tools
- Strong documentation skills; writing readable and reproducible code
- Process improvement mindset; strives to simplify complex processes
- Proficient in Word, PowerPoint, Excel
- Experience working independently and prioritizing multiple deliverables
- Experience managing conflicting priorities and concurrent projects
- Excellent verbal and written communication skills with experience communicating technical information to non-technical audiences
Benefits
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost wellness screenings
- Tobacco cessation and weight management programs
- Confidential counseling
- Financial coaching
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access