Manager, Business Analysis

CVS Health is dedicated to building a world of health around every individual and is seeking a Manager of Business Analysis to develop provider data and manage relationships for reporting processes. This role involves ensuring compliance, gathering data for strategic decision-making, and managing multiple reporting projects while mentoring others and addressing conflicts.

Responsibilities:

• Collect, analyze, and present data related to the provider data and credentialing processes
• Interpret data, identify trends, and draw meaningful conclusions
• Execute timely and accurately on the flagging of sanctioned providers to ensure they are removed from directories and claims payments are stopped and/or recovered
• Maintain complete audit trails to support the work completed
• Support updates to SOPs, job aids, and training materials
• Manage multiple reporting projects with varying due dates and levels of priority
• Identify recurring data issues or control gaps and recommend & execute on process improvements
• Assess the impact of adopting new business analysis advances and make recommendations for their implementation
• Assist with evaluating new technology, tools, and systems that can enhance business processes and operations
• Collaborate with cross-functional teams, under minimal supervision, to gather and document business requirements, translate them into technical specifications, and provide recommendations for technology solutions
• Develop skills outside of an existing comfort zone and encourage others to do the same
• Effectively mentor others
• Address conflicts or issues, engaging in difficult conversations with clients, team members and other stakeholders, escalating where appropriate

Requirements:

• 5+ years of data analysis and reporting experience
• Adept at problem solving and decision making
• Strong attention to detail and documentation accuracy
• Demonstrates experience handling sanctions/exclusions, regulatory or internal audits, and/or similar work with high compliance risk
• Experience in collaboration and cross functional teamwork
• Demonstrates strong verbal and written communication skills, with the ability to clearly articulate complex information to diverse audiences, including leadership and external stakeholders
• Track record of execution and delivery (planning, delivering, and supporting) skills
• Experience in provider data and provider credentialing
• Experience in data warehousing, SQL Queries and PowerBI
• Certified Analytics Professional (CAP)
• QNXT, EPDB and/or PRMS system experience