CVS Health

Manager, Claims Technical Analyst – Medicaid Intake Operations

CVS Health

full-time

Posted on:

Location Type: Remote

Location: ArizonaUnited States

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Salary

💰 $60,300 - $132,600 per year

Tech Stack

About the role

  • Serve as the Technical Subject Matter Expert (SME) for intake rules and matching logic
  • Liaise with providers and internal teams to resolve questions about EDI and Claims Intake rejections
  • Provide second-level expert support for intake claim rejections
  • Analyze large datasets for research and troubleshooting
  • Collaborate with Product Owners and IT teams on system enhancements and fixes
  • Participate in testing and verification of business rules and validations
  • Manage multiple projects and tasks simultaneously while maintaining high-quality results
  • Support Product Owners, Business Owners, and Leads using technical and analytical expertise
  • Communicate effectively across all levels of the organization, including cross-functional teams
  • Write complex SQL queries to join multiple data sources and analyze data for root causes, trends, and opportunities
  • Lead the creation of automated reporting solutions using Tableau, Excel, and other tools to deliver actionable insights
  • Translate complex data analysis into clear, actionable information for non-technical audiences
  • Analyze EDI and Claims intake rejections from internal and external inquiries, including provider calls
  • Track and execute solutions for identified issues
  • Perform User Acceptance Testing for logic changes and enhancements
  • Develop utilities, queries, and processes for post-production checkout of business rules and system fixes

Requirements

  • 3–5 years of experience as a SQL Server power user (coding and developing data extracts)
  • 5+ years of data interpretation and analysis experience
  • 4+ years working with data visualization tools (Tableau, Power BI, or equivalent)
  • expertise in data storytelling and preparing data for presentation in Excel and PowerPoint
  • 5+ years querying large datasets using SQL, SAS, or other data tools
  • strong documentation skills; writes readable and reproducible code
  • proficient in Word, PowerPoint, Excel
  • self-starter with the ability to work independently and prioritize multiple deliverables
  • demonstrated ability to manage conflicting priorities and concurrent projects
  • excellent verbal and written communication skills, able to communicate technical ideas to non-technical audiences
  • strong problem-solving, analytical, and critical thinking skills
Benefits
  • medical, dental, and vision coverage
  • paid time off
  • retirement savings options
  • wellness programs
  • other resources, based on eligibility
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
SQLdata analysisdata visualizationdata storytellingautomated reportingUser Acceptance Testingdata extractiondata interpretationcomplex SQL queriesdata processing
Soft Skills
communicationproblem-solvinganalytical thinkingcritical thinkingdocumentationself-starterprioritizationproject managementcollaborationadaptability