Senior Manager, Provider Claims Diagnostics

Job Opportunity at CVS Health

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 :

Preferred Qualifications :

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

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

This position is eligible for a CVS Health bonus, commission or short-term incentive program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

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 :

For more information, visit https : / / jobs.cvshealth.com / us / en / benefits

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.