[Hiring] Analyst @CVS Health

Role Description

The Contract Coordinator Analyst plays a critical role in supporting the Medicaid Network management team throughout the provider contracting lifecycle for Aetna Better Health of Illinois. This position works hand in hand with the Network Contracting Manager to ensure the accuracy and integrity of provider contract documentation for new providers joining the network, maintaining up-to-date provider information within internal systems, and supports compliance with regulatory and organizational requirements.

• Perform thorough reviews of all incoming contractual documents to ensure completeness and accuracy; work with contracting staff to obtain missing or incomplete documents as needed.
• Work with national provider data service team to load newly contracted providers to the provider record database in a timely manner.
• Audit updated provider records to ensure the correct changes were made to the database; submit corrections as needed.
• Maintain the master repository of participating provider contracts, load newly executed provider agreements to the repository.
• Manage contracting team email box; appropriately respond and triage both internal and external messages to the appropriate parties. Respond to emails within established turnaround times.
• Research and respond to inquiries from providers and internal staff regarding contractual matters such as a provider’s participating status in the Aetna Better Health of Illinois provider network.
• Send out provider welcome packets to newly contracted providers.
• Support internal contract auditing processes as requested.
• Compile, summarize and report on the Health Plan’s compliance with contract submission rules and exception requests, communicating on at minimum, a monthly basis.
• Assist with miscellaneous claims projects/audits and reviewing contracts and plan documents.
• Ensure compliance of health plan, corporate, state, and federal regulations.
• Escalate issues, as necessary, to management in a timely manner.
• Work with members of Network Development and internal department staff to identify process improvement opportunities.
• Perform other duties as assigned.

Qualifications

• 2-5 years of professional work experience, 1 year in the healthcare industry.
• Experience working in TriZetto QNXT.
• Experience with medical terminology.
• Experience working with Microsoft Office Suite.
• Proven ability to manage multiple workflows, prioritize effectively, and meet deadlines.
• Strong written and verbal communication skills, with the ability to convey complex information clearly.

Requirements

• SQL Database Queries.
• Intermediate Microsoft Excel skills (Excel formulas and pivot tables).
• Business reporting.

Education

• GED required, Bachelors preferred.

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.

Pay Range

The typical pay range for this role is: $46,988.00 - $112,200.00. 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 in addition to the base pay range listed above.