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Position Summary
We are looking for a Senior. Manager to own a team for review and processing of supplemental data (Additional diagnosis codes) from various sources like Electronic Medical Record (EMR) Continue of Care Document (CCD), HL7 FHIR data for the use in Medicare and Duals Risk Adjustment.

As an Informatics Senior Manager, you will support the Rhode Island team reporting Affordable Care Act (ACA), Medicare business by recommending appropriate actions, strategies and/or alternatives to meet business CMS reporting needs.  You will accomplish this through:

Fundamental needs:

·        Responsibility for project management for various projects and ensuring tracking to completion

·        Resource management - this position will manage up to 4 resources with different responsibilities and skill sets (business operations, technical resources); ensure guidance and management of teamwork

·        Tracking the needs for reporting, working with stakeholders internal and external to ensure we have all the data (supplemental from vendors, providers) and liaison with sourcing teams.

·        Ensures the end state of the project meets business objective(s) and that all deliverables and due dates are met

·        Highly collaborative process often requires managing relationships across the segments or multiple functional areas

·        Reporting and tracking of submitted files to vendors - identification of key areas to improve upon based on errors

·        Identification of IT requirements dependent on process improvements

·        Reporting to senior leadership on program tracking and major milestones for work streams

·        Own and track regulatory changes

·        Support audit teams

Required Qualifications

• 7+ years of overall relevant experience
• 4+ years of people management experience
• 4+ years of relationship management experience
• 4+ years of healthcare data experience
• 5-8 project/program management experience
• 4+ years of claims experience
• 4+ years of reporting experience
• 4+ years experience working with large datasets using required programmatic tools like SAS, Python.

Preferred Qualifications

• Experience in SAS/SQL/ Python
• Experience with processing files of different types
• 3-5 years of direct regulatory communication experience
• Strong verbal and written communication and interpersonal skills

Education

·        Bachelor’s Degree or equivalent work experience

 

Pay Range

The typical pay range for this role is:

$75,400.00 - $165,954.00

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.  This position also includes an award target in the company’s equity award program. 
 
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 Benefits | CVS Health

We anticipate the application window for this opening will close on: 01/31/2025

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