What are the responsibilities and job description for the Analyst Revenue Cycle position at CVS Health?
The Payer Integrity Analyst is responsible for implementation and managing all aspects of payer contracting processes, specifically for CMS Medicare and all state Medicaid plans.
Support the responsibilities, goals and objectives set forth by Payer Relations Contracting and Revenue Operations leadership. Interact directly with the Regional Contract Directors, managers and colleagues from various teams including but not limited to AR, EPIC, AthenaHealth and other related IT teams to ensure integration of processes related to the successful implementation and management of the payer contracts.
Responsible for:
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Researching, documenting, maintaining and communicating payer details and requirements for implementation in various systems.
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Serving as primary contact for assigned payers, supporting internal & external customers including Regional Directors, Contract Administration, Revenue Cycle Operations and other MinuteClinic teams as appropriate.
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Maintaining all payer fee schedules (Medicare and state Medicaid, but also supporting the team with commercial fee schedule updates).
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Working with MinuteClinic operations in the implementation of new services.
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Supporting training new hires on the team and development of policies, procedures and workflows.
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Proactively identifying and implementing efficiencies across the department including automation opportunities and workflow enhancement opportunities to reduce manual efforts.
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Working with key stakeholders to develop training materials and standardize processes and drive efficiencies.
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Develop and effectively manage relationships with internal and external customers. The Analyst will interact and work with new and existing contracted payers across the country. In addition to the Clinical Operations teams and Payer Relations Regional Directors, the Analyst will interface and work with MinuteClinic administration, Third Party teams (Accounts Receivable, Billing, Credentialing, Call Center, Clinical Ops Teams, Compliance, Legal, Marketing, IT and MinuteClinic Field and Operations Management) to ensure seamless and effective integration of all processes.
Pay Range
The typical pay range for this role is:
Minimum: 40,560
Maximum: 83,400
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
5 or more years of work experience with insurance payers and contract implementation with a strong insurance payer knowledge and contract experience with national, regional, local payers.
Preferred Qualifications
- Experience with government payer reimbursement / fee schedule management.
- Experience with contract management and database system related.
- Experience with effective presentation and ability to impact and influence peers, leaders and key stakeholders.
- Experience understanding data, analyzing reporting and make sound recommendations and business decisions.
Education
HS Diploma required, Bachelors preferred
Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.