The Medicaid Senior Analyst - Client Data will be a key contact for Medicaid Encounter, Response file, and system enhancements and testing within the Encounter Management System. The Senior Analyst - will assist their department peers and managers in enhancing current business processes.
Other duties include:
• Assisting with the configuration and testing of Encounter Files
• Providing support for and leading projects regarding enhancements or changes to new and existing Encounter processes
• Writing User Stories and using the tools that surround varied methodology.
The preferred candidate will have:
• Experience working with NCPDP Standards (D.0, Post Adjudicated), and State Medicaid Encounter file submissions
• Above average Microsoft Excel skills
• Strong problem solving skills with the ability to work independently
• Previous experience with SDLC, requirements gathering, business process testing/validation, and UAT
• Experience or strong ability to work with SQL, Job submission, database libraries
• Ability to create screen mockup
• Knowledge of pharmacy claims and adjudication
• Working knowledge of Rally or Agile testing
• Experience in claim file delivery, claim research, or data file transmission
• Ability to understand complex system functionality
- 2+ years of Pharmacy Benefit Manager (PBM) or Healthcare industry experience
- Strong analytical and problem-solving skills
- Bachelor's Degree from four year college or university
- AS400 experience
Verifiable High School Diploma or GED required.
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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