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.

Position Summary

The CRA (Commercial Risk Adjustment) Business Team is seeking a highly motivated Research Analyst to support the data integrity of our submission process. In this role you be expected to provide data analyst to ensure our data is compliant with CMS (Center for Medicare and Medicaid Services) operational rules. The candidate in this role will assist the team with identifying root cause analysis and data gaps or/and trends concerning our medical data. A strong understanding of professional and institutional claim is desired.
 

Required Qualifications

• 3+ years of medical and/or hospital claims processing OR 2+ years of enrollment experience
• 3+ years of Healthcare Industry knowledge
• 3+ years of Excel experience (specifically with v-look ups)

Preferred Qualifications

• 3+ years of ACAS/HRP experience
• Medicare and Affordable Care Act risk methodology experience a plus.
• Strong organizational skills & time management
• Strong problem-solving skills
• Strong verbal and written communication skills
• Detail oriented and quality minded
• Self driven & strong work ethic
• Strong data analysis capability
• Work collaboratively for individual and team results
• Complete required trainings timely

Education

• Bachelor’s degree or equivalent experience required

Pay Range

The typical pay range for this role is:

$43,888.00 - $85,068.00

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. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
 
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 08/29/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.