About the Role
Title: Senior Analytic Consultant
Location: New Albany Ohio United States of America
Job Description:
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand – with heart at its center – our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work BehaviorsT support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
The Senior Analytic Consultant position is a 100% remote, work from home position. The candidate can live in any state.
The position is primarily Monday through Friday, and the candidate can work the hours of their time zone but must have flexibility for meetings which will occur during 8am-5pm EST.
The Senior Analytic Consultant is responsible for the analyzing issues related to appeals and related areas. One should be proficient in performing root cause analysis and identifying potential corrective actions.
Fundamental Components:
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- Utilize analytical reports involving claims and appeals data to identify issues.
- Coordinate with cross functional team to explain identified issues and participate in solution discussion.
- Facilitate solution identification and implementation of root cause correction actions.
- Able to clearly identify whether the issues are resulting from clinical or administrative process related to appeals.
- Perform ad hoc analysis of small set of issues and ability to extrapolate it to large data set to make meaningful conclusions.
- Prepare presentation materials to explain issues in easy-to-understand format.
- Prepare recommendations based on analysis performed.
- Develops project plans and timelines; responsible for project commitments to quality and on-time deliverables.
- Presents analysis and reports to internal customers and stakeholders.
- Acts as a mentor to other analysts.
?Required Qualifications
– Advanced knowledge of Medicare appeals process and the associated processing system
– 7 or more years’ experience with a combination of one or more of the following skillsets: data analysis, Medicare compliance, Aetna clinical policy
– **AND** ability to analyze data fromdashboard
– Experience translating business requirements into technical requirements for building automation capabilities. CPT codes, medical policy, claims processing knowledge and other supporting areas involved in appeals processing.
– Experience with STAR metric impact related to appeals processing .
– Must be comfortable with using online, independent learning to learn/research new skills/systems.
– Ability to communicate technical ideas and results to non-technical clients in written and verbal form.
– Ability to compose training documents and lead training sessions on new tools.
– Experience leading project teams; strong collaboration skills with the ability to work effectively with all levels of management and staff.
– Strong collaboration and communication skills within and across teams.
– Strong problem-solving, analytical, critical thinking and project management skills.
– Ability to manage conflicting priorities and multiple projects concurrently.