Sr Mgr,Bus Consultant (IC) Position Available In Wake, North Carolina

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 Summary
• : Serves as subject matter expert for the risk assessment of all Medicare Advantage, ACA/IFP, and Medicaid activities and programs across the market under the

Risk Director:

• Provides guidance and consultation for provider design and regulatory compliance
• Leads individuals to develop a high degree of customer service by fielding internal and external inquiries, finding resolutions, or redirecting as appropriate
• Collaborates internally and externally with clients and senior management regarding the organization’s goals and objectives.
• Provides support for the operational interface to ensure tactical business goals are achieved across the organization
• Assists with the execution of CMS required activities and processes including the accuracy and compliance of the annual bid application, expansion application, member materials, and group setup.
• May participate on various committees to represent the Medicare Department
• Designs enterprise wide and/or cross-functional solutions to address business problems.
• Partners with business owners to optimize the achievement of strategic business objectives, to include profitable growth and improved organizational effectiveness.
• Develops reports for the organization regarding current business trends and best practices preparing analysis for senior management, stakeholders, and clients
• Maintains trending data for multiple providers at market level to gauge risk adjustment improvement efforts.
• Knowledge of payer submission sources
• Required Qualifications
• :•3+ years experience in Medicare operations and/or Medicare compliance in a payer setting•Highly proficient in manipulating and building Excel files to analyze Risk•Experience with financial measurement and impact plans•Ability to effectively coordinate multiple projects and programs in a matrix environment and work independently•Familiarity with regulations and statues impacting Medicare Advantage•Highly Proficiency with Microsoft applications including MS Word, Excel, Outlook and PowerPoint•Adjustment data for strategy discussions•Excellent communication, interpersonal, and presentation skills•Risk Adjustment HCC experience •Preferred qualifications:•Medicare Advantage, ACA/IFP, and Medicaid activities •Education•: College Degree or 7 years of relevant experience •Pay Range•The typical pay range for this role is: $67,900.

00

• $182,549.

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. 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 people
• We 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/benefits We anticipate the application window for this opening will close on: 05/03/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.