Senior Manager Business Consulting Payment Integrity
Overview
You will lead strategic initiatives within the Payment Integrity Center of Excellence, driving operational change and process standardization at CVS Health. Reporting to senior leadership, you will collaborate with vendor partners and cross-functional teams to enhance reimbursement accuracy and vendor performance. Your work will directly impact healthcare payment integrity, reducing appeals and claim rework. This role offers high visibility and the chance to shape enterprise-wide payment strategies.
What You'll Do10
- 1Lead monthly invoice and payment reconciliation for vendor reimbursement, ensuring accurate metrics.
- 2Drive innovative solutions aligned with CVS Health's strategic direction, influencing stakeholders across the enterprise.
- 3Manage multiple complex projects from ideation to implementation, coordinating across processes and systems.
- 4Facilitate project planning and analysis, ensuring solutions achieve business benefits and meet objectives.
- 5Participate in all project phases, from discovery through post-implementation support, using HRP and QNXT.
- 6Define and document business requirements, interpreting stakeholder interests for successful delivery.
- 7Proactively manage project risks and issues, escalating to drive resolution and keep deliverables on track.
- 8Conduct root cause analysis to recommend actions and alternatives that address business challenges.
- 9Track progress and build communication plans, keeping all impacted parties informed of next steps.
- 10Develop presentations to consult on capabilities and performance, performing reasonability checks.
Requirements10
- 15+ years in project/program management or policy related to Payment Integrity Vendors.
- 25+ years of direct project and vendor management experience on cross-functional projects.
- 3Expertise in financial and operational metric analysis with vendor contractual acumen.
- 4Track record of managing multiple projects simultaneously, prioritizing deliverables effectively.
- 5Self-starter who works independently and adapts to conflicting priorities.
- 6Proven ability to meet deadlines and milestones while negotiating for resources.
- 7Analytical problem-solver with experience in remediation planning.
- 8Strong communication and presentation skills to diverse audiences.
- 9Experience with ACAS, Medcompass, and HRP systems preferred.
- 10Bachelor's degree in business or technical field, or equivalent work experience.
Salary Insight
$68 - $199k per year
Location
Required Skills
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