Senior Manager, Payment Integrity Strategy

Hispanic Alliance for Career Enhancement; Baton Rouge (LA); On-site; USD 68,000 - 199,000; Full time

Job summary

CVS Health is seeking a Senior Manager - Business Consulting to guide strategic initiatives within the Payment Integrity Center of Excellence. This role partners with vendor partners, senior leaders, and internal stakeholders to drive operational change, analytics, and process improvements across a dynamic healthcare environment.

The ideal candidate demonstrates initiative, strong organization, and the ability to manage multiple projects with diverse objectives.

Qualifications

• 5+ years related experience in project/program management, policy (financial analysis, forecasting and/or procurement/sourcing) associated with external Payment Integrity Vendors.
• 5+ years of direct project/vendor management experience; managing medium-to-large-scale, cross-functional projects.
• Financial/Operational Metric and Performance Analysis and Vendor Contractual Acumen.

Responsibilities

• Leads monthly invoice/payment reconciliation and associated metrics for vendor reimbursement.
• Acts as an advocate for change, influencing others to see the value in project and/or processes; driving innovative and realistic solutions that align to CVS Health's strategic direction.
• Manages the work and deliverables of multiple, complex projects or programs, through ideation to implementation; that impact multiple processes, systems, functions, services, and/or products.
• Cohesive project facilitation, planning, collaboration, analysis, and guidance, ensuring that solutions achieve the expected business benefit or result.
• Active participation in all phases of the program management processes: discovery, assessment, initiation, planning, design, development, testing, execution, deployment, post implementation support.
• Ensure business requirements are defined, documented, and interpreted to meet stakeholder interests; and successful delivery of project end-state that meets business objectives.
• Proactively manage, escalates and mitigate all issues and risks, engaging required parties, and escalating as needed, to drive to resolution and project deliverables remain on track.
• Conduct root cause analysis in support of the business by recommending appropriate actions, strategies and/or alternatives to address business challenges.
• Understand implications of proposed solutions or process changes and supply guidance on alternatives where necessary.
• Track activity progress and build communication plan for implementation to ensure all impacted parties are informed of next steps for completion and project status.
• Effectively manage team/stakeholder expectations and engagement through clear and frequent communication regarding status updates, critical path progress, and variances from project plan.
• Develop and participate in presentation and consultation with business partners on capabilities, performance results and can perform reasonability checks.

Skills

Project management

Vendor management

Strategic planning

Cross-functional collaboration

Communication

Stakeholder management

Education

Bachelor's degree or equivalent

Job description

CVS Health is seeking a Senior Manager - Business Consulting to guide strategic initiatives within the Payment Integrity Center of Excellence. This role partners with vendor partners, senior leaders, and internal stakeholders to drive operational change, analytics, and process improvements across a dynamic healthcare environment.

The ideal candidate demonstrates initiative, strong organization, and the ability to manage multiple projects with diverse objectives.