Senior Analyst, Financial Operations – PDE Reporting

Job not on LinkedIn

🔥 0 minutes ago

🏈 Alabama, Arizona, +42 more states – Remote

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💵 $47k - $112.2k / year

⏰ Full Time

🟠 Senior

💸 Financial Planning and Analysis (FP&A)

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Logo of CVS Health

CVS Health

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

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.

📋 Description

• Review claims and PDE (Prescription Drug Event) errors • Analyze and distribute PDE Rejections reports and analysis to internal and external clients • Serve as liaison between the PDE Reporting Team, PDE Eligibility/Reconciliation, and entities involved with PDE • Download and review Acumen Outliers • Coordinate research with various departments • Submit responses to external clients or Acumen according to CMS deadlines • Assist with weekly PDE meetings • Ensure continuous improvement of Medicare claims data through root cause and impact analysis of errors • Recommend systems and procedure enhancements • Review guidance and ensure compliance with CMS

🎯 Requirements

• Minimum 3 years of experience with government-regulated health programs within financial operations and/or related experience, including Medicaid, Medicare, and/or Exchanges • Working knowledge of Part D plans • Ability to study and correctly interpret CMS Guidance • Compliance with CMS guidance • Excellent written and verbal communication skills • Strong organizational skills and ability to manage multiple projects simultaneously • Excellent time management skills • Proficiency with Microsoft Word and Excel • Proficiency with SQL and/or Python • Bachelor's degree preferred or equivalent work experience required

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program eligibility

Apply Now

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