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Senior Consultant - Provider Data Services - Configuration/R

Company: Jobleads
Location: Kenner
Posted on: June 4, 2021

Job Description:

Join #TeamCVS - We're Hiring! | Senior Consultant - Provider Data Services - Configuration/Research in Kenner, LA US | CVS HEALTH Main menu Why CVS Health Diversity Students Military Events Login Other Sites Prescription Help Contact Search by job title, job category, location, or Military MOS code. Use "Search Map" link to see all locations. Home Senior Consultant - Provider Data Services - Configuration/Research Senior Consultant - Provider Data Services - Configuration/Research Apply Now Job Title: Senior Consultant - Provider Data Services - Configuration/Research Job ID: 1466239BR Location: LA - Kenner Street Address: 2400 Veterans Memorial Blvd Category: Medicaid Job DescriptionProvides consultation on the design, testing and enhancement of claim and contract configurationsetup including technical support to external providers and internal customers. Researches,manipulates and prepares complex data to document program activities and reports on its results.Provides oversight to data quality and provides feedback to various areas in order to improve servicedelivery and enhancement to data configuration efforts. Develops a consultative relationship withexternal providers and internal customers. May lead or act as a business technicalexpert with the planning, development andvalidation of master or detail test claims andstrategies. Performs ongoing research, and supporttasks for existing claims and contractconfiguration. Acts as a business technical consultant inthe design of new applications orenhancements including integration of solutions. Provides Leadership/Coaching/Mentoring;may be a mentor to others. Directs the implementation of programspecific information through providereducation, technology, organizational methods and procedures. Influences enhancements to businessprocesses and system infrastructure toimprove data quality availability and access. Manages customer contact and participatesin internal and external health industrydevelopment efforts (e.g., claims performance measurements). Analyzes complex data for trends, highlightsin-depth interpretations and provides in-depthroot cause analysis. Consults with provider on a regular basis toensure progress is in line with provider'sexpectations and to obtain additional information as needed. Translates complex claim data intoconstructive data and information andmakes recommendations. Defines, identifies, develops andimplements information products to supportstrategic business and operational planning. Illustrates complex information in a clearconcise manner. Develops and conducts presentations andconsultations to existing and prospectiveproviders and internal business areas. Provides workgroup support on projects Influences changes/enhancements tobusiness processes, policies, and systeminfrastructure to improve information quality, availability and access. Promotes and educate providers on culturalcompetency Interprets contractual requirementsincluding federal and state regulations andNCQA. Independent resolution of claim problems.Assist others with resolution of problemsinvolving research into both provider andregulator policy data. Assist with analyzing and the resolution oferror situations that require system research; such as claim audit results. Reviews all management level claim reportsfor validity, accuracy and trends. Ensures internal as well as external financialtransactions associated with unit functionsare appropriately applied. Monitors and reviews designated claimssystem activity and proactively leadsinvestigation of discrepancies and trend fluctuations. Conducts peer to peer training on claimsystems and service functions for new andexisting staff. Makes presentations to peersand customers (internal and external).Required Qualifications- Excellent verbal and written communication skills.- Extensive experience with databases as well interpretation and manipulation of related data.- Healthcare background.- 3-5 years of data interpretation and analysis experience.- Bachelor's degree, technical certification or equivalent work experience.Preferred QualificationsPlease review required qualifications aboveEducationBachelor's degree or equivalent experienceBusiness OverviewAt Aetna, a CVS Health company, 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 are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. 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. Apply Now Chat with a Recruiter Not ready to apply? Join our talent community We are committed to a workplace that supports diversity, inclusion and belonging. 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 comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. Please note that we only accept applications for employment via this site. We provide reasonable accommodations to individuals with disabilities. To request an accommodation, including a qualified interpreter, written information in other formats, translation or other services, please email AdviceandCounsel@ or call 877-805-9511.If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 orcvshealthsupport@ .For technical issues with the Virtual Job Tryout, contact the Modern Hire Help Desk at 1-877-451-1695 orcvs_support@ .The health and safety of our employees, patients, customers, and members is our top priority as we face the impact of COVID-19 together. We encourage you to visit our COVID-19 resource center atto learn more.Please be aware that CVS Health does not will never solicit money or offer payment for job applications, nor do we ask candidates to email or submit any personal information over unsecured channels. To learn more, please visit. EEO IS THE LAW EEO IS THE LAW SUPPLEMENT Changing the future of health care at CVS Health It's a New Day in Health Care at CVS Health CVS Health Colleagues Represent Heart at Work About CVS HealthAt 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 are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. Quick LinksCode of Conduct Corporate Integrity Agreement Policy Diversity Ethics &Human Rights Political Activities & Contributions Corporate InformationAbout Newsroom Thought Leadership Investors Site InformationTerms of Use Privacy Policy Patient Privacy Candidate Privacy Sitemap Copyright 1999 - 2020 CVS Health Loading...

Keywords: Jobleads, Kenner , Senior Consultant - Provider Data Services - Configuration/R, Other , Kenner, Louisiana

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