[Hiring] Senior Manager MPPS Policy Enablement @CVS Health

Role 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.

• Develops and implements strategies to improve healthcare delivery, patient outcomes, and organizational performance.
• Directs health service activities and operations by managing staff, budgets, and resources to ensure efficient workflow and employee adherence to quality and safety standards.
• Delivers leadership and guidance to healthcare teams, including physicians, nurses, administrative staff, and other professionals.
• Establishes quality control methods and quality improvement initiatives to enhance the overall quality of healthcare services.
• Advocates for the needs and rights of patients within the organization by addressing patient concerns, resolving complaints, and implementing strategies to improve patient satisfaction and overall experience.
• Collaborates with other departments, healthcare providers, and external stakeholders to foster meaningful partnerships and ensure seamless coordination of healthcare services.
• Analyzes data related to health services, such as patient outcomes, utilization rates, and financial performance, and leverages this information to generate reports, identify areas for improvement, and make data-driven decisions.
• Ensures compliance with healthcare regulations and policies, such as privacy laws, accreditation requirements, and safety standards.
• Leads and mentors a team of healthcare professionals, providing guidance, and promoting professional development.

Qualifications

• 5+ years medical coding and policy oversight at a managed care payer, specifically administering NCD/LCD policies.
• 3 years leadership experience.
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required and/or obtained within one year of start date in role.
• Bachelor's degree preferred/specialized training/relevant professional qualification.

Requirements

• Payment accuracy configuration experience with Lyric preferred.
• Adept at execution and delivery (planning, delivering, and supporting) skills.
• Adept at business intelligence.
• Adept at collaboration and teamwork.
• Mastery of problem solving and decision making skills.
• Mastery of growth mindset (agility and developing yourself and others) skills.

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.