Digital Issue Research & Resolution Project Manager

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🏈 Ohio – Remote

Although this job is listed in Ohio, this company may be open to hiring remote in other states.

🌪️ Oklahoma – Remote

Although this job is listed in Oklahoma, this company may be open to hiring remote in other states.

+1 more states

🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🤠 Texas – Remote

💵 $54.3k - $159.1k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👷‍♀️ Project Manager

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CVS Health

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Healthcare Insurance • Retail • Wellness

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

📋 Description

• This role is for a position on the Issue Research and Resolution team within Provider Digital Operations organization • Involves support of our Digital Portal and provider electronic data interchange transactions • Receiving issues directly from our Digital Portal users and internal customers • Problem solving/troubleshooting and identification of appropriate systems based on the issue at hand • Prioritization of issues and communicating complex technical details in a business-friendly manner understandable to our customers • Maintain colleague access to the Digital Portal • Review colleague requests for portal access • Utilize reports to remove colleagues who no longer require access or have left the company • Handle incoming support tickets related to Digital Portal functionality • Use knowledge of the Portal and Systems to determine whether the ticket is Portal-specific or not • Respond to resolved tickets in a thoughtful, easily understandable way • Send to EDI Consultants if issue requires more detailed Aetna system analysis or is not Portal-specific • Identify new/trending issues and share with manager for reporting purposes • Represent the Digital Portal during Aetna Immediate Response Team (IRT) issue calls • Act as liaison between the IRT and the Digital Portal team • Monitor Availity downtime/performance issues and share updates as they are available • Assist with communications related to the Digital Portal as needed • Represent the Digital Portal on the Intake & Digital Operations Work Intake Committee • Support the Digital Portal Change Request (CR) process • Act as the liaison between the requester and the Digital Portal team • Share CR form with the requester and meet with them to ensure form is sufficiently completed • Submit the form to the Digital Portal team • Schedule and facilitate bi-weekly CR Review meetings • Act as the single point of contact for Change Requests • Ensure that updates are shared with requesters • Obtain answers to questions on behalf of requesters and communicate the response back

🎯 Requirements

• Working knowledge of the Availity Digital Portal • 2-4 years related work experience in the Provider Contact Center • 2-4 years of EPDB experience • 1-3 years of EWM experience • 1-3 years of Salesforce/ GPS experience • Advanced skills in Outlook • 1-3 years of Service now experience (preferred) • 3-5 years of experience in usage of EWM (preferred) • 1-3 years of ACAS experience (preferred) • 1-3 years of ICD-10, HCPCS, CPT experience (preferred) • Exposure to AEPPAYS (preferred) • Proficient use in Excel

🏖️ Benefits

• Affordable medical plan options • 401(k) plan (including matching company contributions) • 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.