• Manager Medicaid Provider Data Services

    CVS Health (Harrisburg, PA)


    At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

     

    As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

    Position Summary

    + Lead a team of Medicaid Provider Data Services Analysts responsible for loading and maintaining Medicaid Provider data within Aetna QNXT.

    + Team will also include provider operations analyst and potential pre-cred support for implementation activities.

    + Provides assistance and support to other departments, as needed, to obtain crucial or required information from Providers, such as HEDIS, Credentialing, Grievance and Appeals, SIU, etc.

    + Coordinates provider status information with member services and other internal departments.

    + Recruits, develops, and motivates staff. Initiates and communicates a variety of personnel actions including, employment, termination, performance reviews, salary reviews, and disciplinary actions.

    + Monitors staff performance, including weekly staff metrics; coaches and mentors’ staff on performance issues or concerns.

    Required Qualifications

    + 3+ years of recent and related experience in Provider Operations, Provider Relations, or Network operations.

    + 1+ years of experience in Medicaid provider operations.

    + At least 1 year of experience with ensuring the provider data entered into the provider database is accurate and the provider documentation is complete and accurate.

    + 1+ years of experience in managing, coaching, and leading a team of Provider Data Services Analysts.

    + At least 1 years of experience leading or managing a production-oriented team.

    Preferred Qualifications

    + Strong collaboration skills.

    + Strong reporting and data analysis skills and experience.

    + Ability to load balance and prioritize work to meet key performance metrics around TAT and quality.

    + Drive and oversee productivity of staff.

    + Experience with new Medicaid state implementation related to provider requirements.

    + Leadership skills including staff development.

    + Critical thinking and problem-solving skills.

    + Familiarity with Provider Data/Enterprise systems.

    + Strong skills in Microsoft products.

    + QuickBase knowledge.

    Education

    + Bachelor's degree or equivalent professional work experience.

     

    Anticipated Weekly Hours

     

    40

     

    Time Type

     

    Full time

     

    Pay Range

    The typical pay range for this role is:

    $54,300.00 - $145,860.00

     

    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.

     

    Our people fuel our future. 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.

     

    Great benefits for great people

     

    We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

     

    + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .

    + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

    + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

     

    For more information, visit https://jobs.cvshealth.com/us/en/benefits

     

    We anticipate the application window for this opening will close on: 01/31/2026

     

    Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

     

    We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.