[Hiring] Provider Data Service Specialist @CVS Health

Role Description

Provides operational support and performs data maintenance and clean-up for data transactions (basic to complex). In addition, performs data transactions and maintenance associated with projects, expansions, and new product implementations. Works with other departments to ensure quality provider data to our members.

• Maintains and updates provider demographic and contract information, including contractually sensitive or complex transactions, in appropriate systems in support of claims adjudication and provider directory.
• Works collaboratively with internal/external constituents to implement new networks and complex contractual arrangements.
• May provide technical and/or functional leadership within unit (i.e., team lead).
• Performs validation of system enhancements.
• Identifies, researches and conducts root cause analyses (e.g. problem providers identified by PST, trends from routine PDS audits) and collaborates cross-functionally within the organization to recommend process improvements.
• Conducts and manages audits of provider information and escalates issues for resolution as appropriate.

Qualifications

• 1+ years of maintaining information within multiple databases.
• Demonstrated ability to handle multiple assignments.
• Demonstrated ability to work in a production environment.
• Proficient in Microsoft Office Applications.
• Proficient in Excel.
• Demonstrated success prioritizing work and the ability to multi-task in a fast-paced environment.
• Demonstrated success in collaborating with others to meet/exceed expectations.
• Experience providing clear and concise written and verbal communications.

Requirements

• EPDB experience (preferred).
• Associate's degree or equivalent experience.

Benefits

• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.

Company Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.