Senior Analyst - Claims Business Analysis

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

• Provides consultation on the design, testing and enhancement of information product including technical assistance and product development support to external and internal customers.
• Researches, manipulates and prepares complex data to document program activities and reports on its results.
• Provides oversight to data quality and provides feedback to various areas in order to improve service delivery and enhancement to design efforts.
• Develops a consultative relationship with internal/external customers.

QNXT is REQUIRED

Excel is REQUIRED

• May lead or act as a business technical expert with the planning, development and validation of master or detail test plans and strategies.
• Performs ongoing research, and support tasks for existing systems.
• Leads or acts as a business technical expert in the design of new applications or enhancements including integration of solutions.
• Provides Leadership/Coaching/Mentoring; may be a mentor to others.
• Directs the implementation of program specific information through education, technology, organizational methods and procedures.
• Influences enhancements to business processes and system infrastructure to improve data quality availability and access.
• Manages customer contact and participates in internal and external health industry development efforts (e.g., performance measurements).
• Analyzes complex data for trends, highlights in-depth interpretations and provides in-depth root cause analysis.
• Consults with client on a regular basis to ensure progress is in line with customer’s expectations and to obtain additional information as needed.
• Translates complex data into constructive data and information and makes recommendations.
• Defines, identifies, develops and implements information products to support strategic business and operational planning.
• Illustrates complex information in a clear concise manner.
• Develops and conducts presentations and consultations to existing and prospective customers and internal business areas.
• Provides workgroup support on projects.
• Educates customer on the value, use and interpretation of information product.
• Influences changes/enhancements to business processes, policies, and system infrastructure to improve information quality, availability and access.
• Evaluates available software and data to deliver better business solutions.
• This position is open to fully remote candidates. If located in Phoenix, AZ, you may be expected to be hybrid.

• 6+ Months Working experience reading and understanding claims.
• Working knowledge of reading and reviewing claim and coding types.
• 6+ Months of intermediate to advanced level knowledge of Excel (ability to manipulate large lines of data, work with formulas etc.)
• 6+ Months QNXT.
• Excellent verbal and written communication skills.
• MS Office (Word, Access DB and Info Path etc.).
• Extensive experience with databases as well interpretation and manipulation of related data.
• Healthcare background.

• MS SQL experience is a plus.
• Remedy (Ticket Tracking) experience is a plus.
• 3-5+ years of data interpretation and analysis experience.
• Bachelor's degree preferred.
• We support a hybrid work environment. If selected and you live near a suitable work location, you may be expected to comply with the hybrid work policy. Under the policy, all…