Talent.com
Senior Manager, Provider Claims Diagnostics

Senior Manager, Provider Claims Diagnostics

Austin StaffingAustin, TX, US
Hace 1 día
Tipo de contrato
  • A tiempo completo
Descripción del trabajo

Senior Manager, Accounts Receivable Diagnostics

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. This position can be work at home or hybrid, dependent on where the candidate lives. The Provider Experience, Interoperability, Digital Solutions & Provider Operations organization provides foundational operational / enabling support for provider partners and the Network teams that directly interact with these providers. The Strategic Planning and Support team plays a key role in tracking and monitoring the health of critical business functions, supporting strategic initiatives, and partnering to elevate insights that can positively impact provider experience. The Senior Manager, accounts receivable Diagnostics, will leverage existing & new methodologies to help review, understand, and identify process improvements across key provider journeys including self-service / digital transactions, claims management, dispute resolution, and more. They will directly support certain strategic Provider Experience initiatives that enable our providers to deliver high quality, accessible, and affordable care for our members, work with the local market leadership team to share insights and learnings and stay connected to and translate key risks and wins to other parts of the organization. This position will directly support several distinct activities, including :

  • Invest in targeted reviews of specific datasets / trends to bring visibility to process improvement opportunities, both internal and external
  • Serve as an internal subject matter expert to provide broader training & awareness regarding emerging learnings to help scale identified improvements
  • Develop presentations, case studies, timelines, and related material to successfully implement strategy or change initiatives, including executive level presentations
  • Partner with other teams within the organization to rationalize findings & lessons learned related to provider abrasion and facility / physician claim issues
  • Help bring 'voice of the provider' into key workflow reviews, workshops, and related planning & prioritization exercises
  • Partner with local market teams to understand and account for trends impacted by contractual or other market-specific dynamics
  • Monitor existing internal dashboards such as the Provider Experience and Analytics Tool to assess trends, surface outlier performance, and elevate progress
  • Leverage strong project management skills to monitor implementation and achieve successful outcomes across multiple projects
  • Establish contacts in diverse business areas to keep informed of new learnings and impact to Provider Experience

Required Qualifications :

  • A minimum of 7 years' experience in one or more of the following areas : provider revenue cycle operations / optimization, payer relations, healthcare analytics.
  • Ability to work collaboratively in a cross-functional team environment to solve challenging issues and identify opportunities for improvement.
  • Ability to effectively interact with all levels of management.
  • Demonstrates flexibility to support rapid adjustments to strategy and priorities to meet changing business requirements.
  • Conveys strong sense of urgency to drive issues to closure.
  • Demonstrated ability to analyze & synthesize quantitative and qualitative data to derive actionable solutions.
  • Experienced presenter with ability to provide different views for different levels (e.g., executive vs. end user).
  • Strong project management experience.
  • Excellent verbal and written communication skills.
  • Strong organizational skills.
  • Preferred Qualifications :

  • Prior experience across common claims management tools / resources including Availity provider portal, clearinghouse vendor partners, Electronic Data Interchange (EDI), practice management software, etc.
  • Prior experience with Provider Network functions / processes and market dynamics.
  • Working knowledge of QNXT, HRP, and ACAS.
  • Education :

  • Bachelor's degree preferred or a combination of work experience and education.
  • Pay Range :

    The typical pay range for this role is : $67,900.00 - $199,144.00

    Great benefits for great people :

    We take pride in our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include :

  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
  • We anticipate the application window for this opening will close on : 12 / 13 / 2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex / gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

    Crear una alerta de empleo para esta búsqueda

    Claim Manager • Austin, TX, US

    Ofertas relacionadas
    • Oferta promocionada
    Travel Nurse RN - Home Health

    Travel Nurse RN - Home Health

    Triage StaffingKyle, TX, US
    A tiempo completo
    Triage Staffing is seeking a travel nurse RN Home Health for a travel nursing job in Kyle, Texas.Job Description & Requirements. Travel Nursing : Home Health Kyle.Location : ...Mostrar másÚltima actualización: hace 3 días
    • Oferta promocionada
    Manager, Provider Configuration

    Manager, Provider Configuration

    Austin StaffingAustin, TX, US
    A tiempo completo
    Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases.Maintains critical provider information on all claims and provider databases.Sy...Mostrar másÚltima actualización: hace 4 días
    • Oferta promocionada
    RN-Antepartum

    RN-Antepartum

    AscensionElgin, TX, US
    A tiempo completo
    Various health insurance options & wellness plans.Retirement benefits including employer match plans.Long-term & short-term disability. Employee assistance programs (EAP).Parental leave & adoption a...Mostrar másÚltima actualización: hace 6 días
    • Oferta promocionada
    Senior Manager, Provider Claims Diagnostics

    Senior Manager, Provider Claims Diagnostics

    Texas StaffingAustin, TX, US
    A tiempo completo
    Senior Manager, Accounts Receivable Diagnostics.At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about tr...Mostrar másÚltima actualización: hace 1 día
    • Oferta promocionada
    Senior Claims Manager

    Senior Claims Manager

    MWHDel Valle, TX, US
    A tiempo completo
    US with a rich history dating back to the 19th century.As a company committed to our team's well-being and growth, we offer a supportive work environment, opportunities for advancement, and the...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    General & Product Liability Complex Claim Examiner - Multi-State Preferred - Hybrid - Sedgwick Office

    General & Product Liability Complex Claim Examiner - Multi-State Preferred - Hybrid - Sedgwick Office

    Austin StaffingAustin, TX, US
    A tiempo completo
    General & Product Liability Complex Claim Examiner - Multi-State Preferred - Hybrid.By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day fo...Mostrar másÚltima actualización: hace 4 días
    • Oferta promocionada
    RN Asst Mgr-Nursing Oncology

    RN Asst Mgr-Nursing Oncology

    AscensionElgin, TX, US
    A tiempo completo
    Hospital : Ascension Seton Medical Center Austin .Various health insurance options & wellness plans.Retirement benefits including employer match plans. Long-term & short-term disability.Employee assi...Mostrar másÚltima actualización: hace 6 días
    • Oferta promocionada
    RN- Antepartum

    RN- Antepartum

    AscensionElgin, TX, US
    A tiempo completo
    Various health insurance options & wellness plans.Retirement benefits including employer match plans.Long-term & short-term disability. Employee assistance programs (EAP).Parental leave & adoption a...Mostrar másÚltima actualización: hace 6 días
    • Oferta promocionada
    RN-Interventional Structural Heart

    RN-Interventional Structural Heart

    AscensionElgin, TX, US
    A tiempo completo
    Ascension Seton Medical Center Austin.Various health insurance options & wellness plans.Retirement benefits including employer match plans. Long-term & short-term disability.Employee assistance prog...Mostrar másÚltima actualización: hace 6 días
    • Oferta promocionada
    Occupational Therapist (OT) - Home Health - PRN

    Occupational Therapist (OT) - Home Health - PRN

    Enhabit Home Health & HospiceBASTROP, TX, US
    A tiempo completo
    Are you in search of a new career opportunity that makes a meaningful impact? If so, now is the time to find your calling at Enhabit Home Health & Hospice. As a national leader in home-based care, E...Mostrar másÚltima actualización: hace 23 horas
    • Oferta promocionada
    RN-Emergency Dept

    RN-Emergency Dept

    AscensionBastrop, TX, US
    A tiempo completo
    Various health insurance options & wellness plans.Retirement benefits including employer match plans.Long-term & short-term disability. Employee assistance programs (EAP).Parental leave & adoption a...Mostrar másÚltima actualización: hace 6 días
    • Oferta promocionada
    RN Med Surg / Tele

    RN Med Surg / Tele

    Baylor Scott & White HealthLeander, TX, US
    A tiempo completo
    Unit : 2 West - Med Surg / Telemetry .Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-f...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Director, Clinical Programs

    Director, Clinical Programs

    Austin StaffingAustin, TX, US
    A tiempo completo
    By joining Sedgwick, you'll be part of something truly meaningful.It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your c...Mostrar másÚltima actualización: hace 1 día
    • Oferta promocionada
    Physical Therapist (PT) - Home Health - PRN

    Physical Therapist (PT) - Home Health - PRN

    Enhabit Home Health & HospiceBASTROP, TX, US
    A tiempo completo
    Are you in search of a new career opportunity that makes a meaningful impact? If so, now is the time to find your calling at Enhabit Home Health & Hospice. As a national leader in home-based care, E...Mostrar másÚltima actualización: hace 23 horas
    • Oferta promocionada
    Travel Registered Nurse (RN) - Labor & Delivery (L&D) - $2,017 per week in Kyle, TX

    Travel Registered Nurse (RN) - Labor & Delivery (L&D) - $2,017 per week in Kyle, TX

    TravelNurseSourceKyle, TX, US
    A tiempo completo
    TravelNurseSource is working with Gifted Healthcare to find a qualified Labor / Delivery RN in Kyle, Texas, 78640!.The Gifted Healthcare Experience . Gifted Healthcare is an award-winning travel nursi...Mostrar másÚltima actualización: hace 13 días
    • Oferta promocionada
    RN-Labor & Delivery

    RN-Labor & Delivery

    AscensionElgin, TX, US
    A tiempo completo
    Various health insurance options & wellness plans.Retirement benefits including employer match plans.Long-term & short-term disability. Employee assistance programs (EAP).Parental leave & adoption a...Mostrar másÚltima actualización: hace 5 días
    • Oferta promocionada
    Dialysis Program Manager Registered Nurse - RN

    Dialysis Program Manager Registered Nurse - RN

    Fresenius Medical CareKyle, Texas, US
    A tiempo completo
    Responsible for the day-to-day program operations and supporting the growth of the assigned single site Home Therapies program in coordination with the Business Unit management, in-center staff and...Mostrar másÚltima actualización: hace 19 días
    • Oferta promocionada
    Travel Registered Nurse (RN) - Long-Term Care (LTC) - $1,092 per week in Bartlett, TX

    Travel Registered Nurse (RN) - Long-Term Care (LTC) - $1,092 per week in Bartlett, TX

    TravelNurseSourceBartlett, TX, US
    A tiempo completo
    TravelNurseSource is working with Medical Solutions to find a qualified Long-Term Care RN in Bartlett, Texas, 76511!.A facility in Bartlett, TX is seeking its next amazing RN (Registered Nurse) to ...Mostrar másÚltima actualización: hace 13 días