Note: The job is a remote job and is open to candidates in USA. CVS Health is building a world of health around every individual, aiming to simplify healthcare. The Provider Data Services Administrator will provide operational support, maintain and optimize provider data, and ensure data quality for claims adjudication and network expansion.
Responsibilities
- Maintains and updates provider demographic and contract information, including contractually sensitive or complex transactions, in appropriate systems in support of claims adjudication and provider directory
- Works collaboratively with internal/external constituents to implement new networks and complex contractual arrangements
- Will provide technical and/or functional leadership within unit (i.e., team lead)
- Performs validation of system enhancements
- Identifies, researches, and conducts root cause analyses (e.g. problem providers identified by PST, trends from routine PDS audits) and collaborates cross-functionally within the organization to recommend process improvements
- Conducts and manages audits of provider information and escalates issues for resolution as appropriate
Skills
- Provider Data Services background (3-5 years)
- Demonstrated ability to handle multiple assignments
- Demonstrated ability to facilitate meetings and make accurate records
- Proficient in Microsoft Office Applications with Advanced skills in Excel
- Demonstrated success prioritizing work and the ability to multi-task in a fast-paced environment
- Demonstrated success in collaborating with others to meet/exceed expectations
- Experience providing clear and concise written and verbal communications
- At least 3 to 5 years EPDB experience
- SCM Provider Tab maintenance experience
- Demonstrated ability to utilize analytical and independent thinking skills
Benefits
- This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families.
- The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
- This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
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