Project Lead

Project Lead

Job Overview

Location
Phoenix, Arizona
Job Type
Full Time Job
Job ID
32093
Date Posted
8 months ago
Recruiter
Marua Konsta
Job Views
61

Job Description

Job Description
Reporting to CSRA director, Medicaid Benefit Analyst will perform analysis of source materials supplied by Health Plans, and document requirements for benefit administration in business application systems.

Position will be responsible for the research and review of State, CMS and internal documentation to determine correct benefits structure and system configuration. Candidate will review and update existing benefit grids and will be responsible for creating grids for new lines of business. Responsibilities also include issue resolution, ongoing system change request review, and periodic audit of the current benefit set up to ensure accuracy. Position will be a key resource and business partner to our Health Plans and CSRA Management for all benefit administration items.

Required Qualifications
Proven track record in meeting project milestones, strong management skills and the ability to work independently to achieve timely results
Collaborate with internal and external partners to produce accurate results
Independently research State, CMS and other internal and external source documentation to determine correct benefit structure and system set up requirements
Issue research and resolution
Time management to complete work according to documented service level agreements
Previous experience with claim processing and research resolution
Ability to interpret State and Health Plan source documentation and understanding of its relation to internal documentation and QNXT output
Knowledge of medical coding and terminology, certified coder not required
QNXT is Plus!

COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.

  • If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
  • If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications
Knowledge of QNXT and Medicaid

Education
No minimum requirement

Business Overview
At Aetna, a CVS Health company, 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 are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. 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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