Senior Manager, Business Consultant (IC)

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

As a Senior Business Consultant within the Revenue Integrity COE organization, you will be leading Risk Adjustment technical activities, not limited to electronic medical record data extraction, reconciliationand aggregation, and financial and operational reporting.

Fundamental Components :

Responsible for providing guidance and direction to external vendors, external consultants, team members and / or matrixed staff as required to lead Risk Adjustment Revenue Integrity initiatives.

Accountable for transferring knowledge, best practices (external and internal), methodology and tools across organizations.

Responsible for vendor production management activities with the goal of optimizing Vendor efficiency / effectiveness.Provides on-going support, development & maintenance of reporting, vendor data feeds, process improvement, analytics and projections to ensure vendor initiatives are meeting desired outcomes.

This position also supports coordination across all shared services and vendors to assure data integrity and data validation processes are in place.

Conducts periodic updates of analytical routines and department production systems. Investigates and evaluates alternative solutions to meeting business needs.

Ability to assess and evaluate best practices across vendors, lead change efforts to implement learnings, drive accountability and and act as a SME for vendor processes and reporting.

Required Qualifications :

• Must have experience with IT application development lifecycles, methodologies.
• Experience with SAS / SAS EG / Python / SQL server in data analytics and manipulation
• Experience with BI tools, including Tableau, Power BI, Quicksight, etc
• Experience with SQL Server, Redshift or other database programming
• Vendor management experience
• Ability to perform testing functions.
• Participates in system design.
• Ability to audit the accuracy of reporting against source documents / reports / databases.
• Ability to implement auditing procedures
• 7+ years of healthcare, health insurance, or relevant combination of experience
• Strong problem-solving, analytical, critical thinking and project management skills.
• 7+ years experience with several of the following methodologies : management consulting, project consulting, business process consulting, financial strategic analysis strategic business planning, and / or risk management consulting.
• Experience with CMS Risk Adjustment programs

Preferred Qualifications

• Experience influencing others by turning data into meaningful and actionable information.
• Attention to detail
• Strong negotiation skills
• Experience documenting business processes, as well as, recommending and implementing improvement strategies.
• Ability to operate independently
• Self starter and inquisitive

Education

Bachelor's degree in Mathematics, Economics, Statistics, Computer Science, Actuarial Science, Social Science, Healthcare or related discipline or equivalent professional work experience.

Pay Range

The typical pay range for this role is :

$67,900.00 - $174,200.00

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.

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.