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.
At Aetna Better Health of Texas, we are committed to helping people on their path to better health. By taking a total and connected approach to health, we guide and support our members so they can get more out of life, every day. We are looking for people like you who value excellence, integrity, caring and innovation. As an employee, you’ll join a team dedicated to improving the lives of Texas members. We value diversity and are dedicated to helping you achieve your career goals.
Position Summary
This position can be Work From Home anywhere in the United States. Preferred TX
- Maintains the Provider Data (demographic and contractual) for all network and non-network providers.
- Ensures all provider information is accurately recorded and maintained to provide for proper reimbursement and member access (i.e., directory listings).
- Develops and maintains standards for database integrity, corrective actions, database alignment, and manages communication processes with other departments regarding database improvements.
- Provides support for baseline provider data transactions that cannot be administered automatically through the provider database due to system limitations and/or data integrity issues.
- Performs baseline demographic transaction updates in provider system applications in support of claim adjudication and Provider directory.
- Performs intake triage and responds to network inquiries, escalates when necessary.
- Provides on-going department support in research and analysis essential to resolving concerns/issues raised by providers and other internal/external customers.
- Conducts audits of provider information and escalates issues for resolution as appropriate.
- Automates and manually loads, maintains, and resolves all new and revised participating provider data transactions (basic to complex).
Required Qualifications
- Demonstrated ability to handle multiple assignments.
- 1-3 years' of Provider Data Services background.
- 1-3 years' Network background.
- Advanced Microsoft Excel skills including knowledge of formulas and VLOOKUPs.
- 1+ years' QNXT experience.
Preferred Qualifications
- Strong communication skills.
- Ability to trouble shoot technical and data issues
- Ability to assist team members
- Ability to offer process improvement ideas
Education- Bachelor's degree or equivalent experience.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$46,988.00 - $102,000.00This 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.