Senior Provider Relations Analyst — Claims & Ops

CVSHealth; New Jersey; On-site; USD 50,000 - 122,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Senior Analyst to support provider-facing operations with a focus on MAPL-related activities, ensuring accurate claims processing, issue resolution, and provider engagement. This role partners cross-functionally to analyze data, resolve escalations, and drive operational improvements across provider systems and processes.

Key responsibilities include detailed claims analysis, managing provider inquiries and tickets (NEF/SNOW), escalating issues as needed, educating

Qualifications

• 2-5 years of professional work experience, 1 year in healthcare

Responsibilities

• Conduct detailed claims and data analysis within established turnaround times
• Manage intake and resolution of operational requests and provider inquiries
• Escalate system and data issues and support root cause analysis
• Educate providers on claims and payment policies, plan design, and operational processes
• Collaborate with contracting and network teams to address operational concerns
• Perform root cause analysis on recurring provider issues to identify process improvements

Skills

Strong communication

Multi-tasking

Microsoft Office Suite

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

CVS Health is seeking a Senior Analyst to support provider-facing operations with a focus on MAPL-related activities, ensuring accurate claims processing, issue resolution, and provider engagement. This role partners cross-functionally to analyze data, resolve escalations, and drive operational improvements across provider systems and processes.

Key responsibilities include detailed claims analysis, managing provider inquiries and tickets (NEF/SNOW), escalating issues as needed, educating