Medicare PDE Data & Compliance Analyst

CVSHealth; California; Vor Ort; USD 47.000 - 112.000; Vollzeit

Benefits dieser Stelle

Medical, dental, vision

Paid time off

Retirement savings

Wellness programs

Zusammenfassung

CVS Health is seeking a detail‑oriented analyst to review claims and PDE errors, analyzing PDE Rejections and distributing reports to clients and internal teams. You will coordinate cross‑department research and ensure responses meet CMS deadlines, partnering with the PDE Reporting Team and Eligibility/Reconciliation groups.

You should bring 3+ years of experience with government-regulated health programs, proficiency in SQL and Python, and solid communication skills to support timely

Qualifikationen

• Excellent written and verbal communication skills.
• Strong organizational skills and ability to manage multiple projects simultaneously.
• Excellent time management skills as requests are time sensitive.
• Proficiency with Microsoft Word and Excel.
• Proficiency with SQL and/or Python.

Aufgaben

• Review claims and PDE (Prescription Drug Event) errors and analyze PDE Rejections reports.
• Coordinate research with departments and submit responses to external clients or Acumen per CMS deadlines.
• Serve as liaison between PDE Reporting Team, PDE Eligibility/Reconciliation and related entities.
• Assist with weekly PDE meetings and contribute to continuous improvement of Medicare claims data.
• Ensure compliance with CMS guidance and relevant regulatory requirements.

Kenntnisse

Communication

Organizational skills

Time management

SQL

Python

Excel

Word

Ausbildung

Bachelor's degree preferred

Tools

SQL

Python

Excel

Microsoft Word

Jobbeschreibung

CVS Health is seeking a detail‑oriented analyst to review claims and PDE errors, analyzing PDE Rejections and distributing reports to clients and internal teams. You will coordinate cross‑department research and ensure responses meet CMS deadlines, partnering with the PDE Reporting Team and Eligibility/Reconciliation groups.

You should bring 3+ years of experience with government-regulated health programs, proficiency in SQL and Python, and solid communication skills to support timely