CVS Health
Analyst - Medicaid Network Operations
IL - Work from home, USA · Full-time
Sponsorship not specified$47k-$112kDetected 1 day ago
SQLExcelAuditingProcess ImprovementResearchCommunicationMicrosoft Office
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odds of building a lasting career here
42Risky
Cap-exempt (no lottery)0
Sponsors this role100
Entry-level history0
PERM / green-card track0
Lottery odds (Level I)39
Fits your clock70
Thin sponsorship signal and lottery-bound (~15% per draw). A low-probability bet with your clock running. Prioritize cap-exempt roles and proven entry-level sponsors first.
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About the role
- The Contract Coordinator Analyst plays a critical role in supporting the Medicaid Network management team throughout the provider contracting lifecycle for Aetna Better Health of Illinois.
- See breakdown of specific job responsibilities below:
Responsibilities
- Perform thorough reviews of all incoming contractual documents to ensure completeness and accuracy; work with contracting staff to obtain missing or incomplete documents as needed
- Maintain the master repository of participating provider contracts, load newly executed provider agreements to the repository
- Manage contracting team email box; appropriately respond and triage of both internal and external messages to the appropriate parties. Respond to emails within established turnaround times
- Support internal contract auditing processes as requested
- Assist with miscellaneous claims projects/audits and reviewing contracts and plan documents
- Perform other duties as assigned
Requirements
- Experience working in TriZetto QNXT
- Experience working with Microsoft Office Suite
- Strong written and verbal communication skills, with the ability to convey complex information clearly
Nice to have
- SQL Database Queries
- Intermediate Microsoft Excel skills (Excel formulas and pivot tables)
- Business reporting
- GED required, Bachelors preferred
Skills
- Work with national provider data service team to load newly contracted providers to the provider record database in a timely manner
- Audit updated provider records to ensure the correct changes were made to the database; submit corrections as needed
Compensation
- $46,988.00 - $112,200.00
- This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
- The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
- This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
- We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
- The typical pay range for this role is:
Benefits
- 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.
- Research and respond to inquiries from providers and internal staff regarding contractual matters such as a provider's participating status in the Aetna Better Health of Illinois provider network
- Compile, summarize and report on the Health Plan's compliance with contract submission rules and exception requests, communicating on at minimum, a monthly basis
- Ensures compliance of health plan, corporate, state, and federal regulations
- Great benefits for great people
- The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
- Additional details about available benefits are provided during the
- application process and on Benefits Moments.
Company info
- Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
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This listing is sourced directly from CVS Health's careers page and normalized into a canonical job model.