Senior Manager, Medicaid Revenue Integrity

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryReporting to the Lead Director of Medicaid Revenue Integrity, the Senior Manager will work closely with various Revenue Integrity Lead Directors and subject matter experts across the Medicaid business to establish and champion market level revenue integrity excellence. This position is responsible for supporting all assigned market level risk adjustment activities and processes related to complete and accurate diagnosis capture through provider and member engagement.In support of the Revenue Integrity Medicaid Performance Management Office (PMO) this position will lead the work and deliverables of multiple complex projects, focusing on process improvement, production, and data analysis. This individual should have proven project management of multiple complex projects simultaneously and demonstrate understanding of root cause analysis. This position may act as a liaison with other key business areas, internally and externally. The Medicaid Revenue Integrity Senior Manager will play a critical role in extracting, analyzing, and interpreting healthcare and financial data from multiple sources to address business opportunities regarding population health management, health and economic outcomes, and other business needs.Required Qualifications• 5+ years of data analytics experience in healthcare environment or equivalent work environment• 5+ years of Project Management experience managing multiple projects simultaneously and meeting deadlines.• 2+ years of leadership experience• Strong analytical and problem-solving skills• Proficiency in Microsoft suite and data visualization tools (i.e. Excel, PowerPoint, Tableau etc)• Excellent communication, presentation/creating presentations, and writing skills.• Highly organized with excellent attention to detailPreferred Qualifications• Knowledge of Risk Adjustment, preferably Medicaid• Detail-oriented with a disposition to probe into technical details for accuracy and completeness• Design and code efficiently in SQL, SAS, or similar programming languageEducation Bachelor's Degree or equivalent work experiencePay RangeThe typical pay range for this role is:$67,900.00 - $182,549.00This 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.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 05/16/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.