Senior MPPS Experience & Policy Optimization Lead

4062 Aetna Resources, LLC; Town of Florida (NY); Hybride; USD 68 000 - 183 000; Plein temps

Avantages offerts par ce poste

Medical insurance

Dental insurance

Vision insurance

Bonus program

Résumé du poste

CVS Health is seeking a Senior Manager MPPS Experience Optimization to lead data-driven strategies that enhance medical and payment policy effectiveness and improve the provider experience across the claims lifecycle.

You will partner with policy, analytics, coding, and provider teams to identify opportunities, implement changes, and measure outcomes in a complex, regulated healthcare environment. Strong leadership and communication skills are essential.

Qualifications

• 5+ years of experience in healthcare policy or related healthcare functions.
• Supervisory or formal people-leadership experience required.
• Strong knowledge of healthcare reimbursement, claims processing, medical and/or payment policy, and coding concepts (CPT, HCPCS, ICD-10).
• Experience leading complex, cross-functional initiatives from analysis to measurement.
• Ability to communicate complex findings and influence decision-making.

Responsabilités

• Identify and advance policy optimization opportunities across pre- and post-payment processes.
• Lead cross-functional initiatives with analytics, clinical, and operations teams to improve provider experience.
• Develop governance and prioritization practices for optimization initiatives.
• Provide strategic leadership and coaching to team members and stakeholders.

Connaissances

Healthcare analytics

Policy optimization

Cross-functional leadership

Data-driven decision making

Formation

Bachelor’s degree in healthcare administration

Healthcare credential (CPC/CCS/RHIT)

Description du poste

CVS Health is seeking a Senior Manager MPPS Experience Optimization to lead data-driven strategies that enhance medical and payment policy effectiveness and improve the provider experience across the claims lifecycle.

You will partner with policy, analytics, coding, and provider teams to identify opportunities, implement changes, and measure outcomes in a complex, regulated healthcare environment. Strong leadership and communication skills are essential.