Analyst, Plan Sponsor Services Technical

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. Position Summary The Analyst, Plan Sponsor Services Technician is responsible for entering and maintaining client and provider information within internal systems, ensuring data accuracy and completeness. This role supports ongoing updates for new, terminated, and modified client records, validates required documentation, participates in process and audit review meetings, and consistently meets monthly accuracy and quality standards. Required Qualifications 2-4 years of Health insurance industry experience. 2-4 years of experience maintaining client and provider data within healthcare or insurance systems. 2-4 years of experience supporting plan sponsors, or provider networks. Experience working in a fast-paced administrative or operational environment. Strong attention to detail with a proven ability to maintain data accuracy. Preferred Qualifications Managed Care experience Associate's degree preferred. Education High School Diploma or GED required. Anticipated Weekly Hours 40 Time Type Full time <p style="t

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. Position Summary The Strategic Proposal Management (SPM) organization is solely responsible for developing and executing all proposals and proposal-related activity for CVS Health. Our team is responsible for creating proposals that clearly demonstrate that CVS Health is uniquely positioned to deliver significant benefits to health plan sponsors through effective cost management solutions and innovative programs that engage plan members and promote healthier and more cost-effective behaviors. Through our unique suite of assets, CVS Health is reinventing pharmacy to offer innovative solutions that help people on their path to better health. We effectively manage pharmaceutical costs and improve health care outcomes through our pharmacy benefit management (PBM), mail order and specialty pharmacy division, CVS Caremark® Pharmacy Services, our CVS/pharmacy® retail stores, our retail-based medical clinic subsidiary, MinuteClinic® and our online retail pharmacy, CVS.com®. We are focused on enhancing access to care, lowering overall health care costs for plan members and payors, and improving health outcomes. The main responsibility of the position involves managing all phases of our PBM proposals process including: Formatting proposals to meet internal marketing specifications Responding to RFP questions using a database of internal Subject Matter Expert reviewed conten

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. Position Summary Seeking a Senior Analyst to join the Group Medicare Advantage Actuarial team to assist with Part C analysis & pricing. More specifically, this role will be responsible for the following: Updating assumptions used in pricing Part C Maintaining existing portfolio view reporting Supporting plan sponsor experience refund reconciliations and UW data/reporting needs Collaborating with Underwriting on plan sponsor pricing opportunities for both new business and renewal business Required Qualifications Bachelor’s degree along with 3&#43; years related experience Prior healthcare experience Experience working with large and detailed data sets Preferred Qualifications Strong communication and collaboration skills Solid technical, analytical, and creative problem-solving skills Be organized, data driven, statistically minded and demonstrate an attention to detail Be self-motivated, intellectually curious with a desire to continuously improve processes Be adaptable as business needs and priorities evolve Familiarity with Medicare Part C and/or Group pricing Education Bachelor’s degree or higher in act

Integra FEC (Financial Economic Consulting) is hiring entrepreneurial and quantitatively-skilled individuals with data analytics experience who are interested in applying their skills to identify, investigate and analyze fraud in various domains, including finance, healthcare and cryptocurrencies. Integra is a boutique economic consulting and forensic analytics firm that has worked with government agencies and private entities to analyze many complex and high-profile schemes. Our team applies data science and econometric techniques and intensely values each employee to take initiative and to be curious while operating as a data detective to solve complex problems. Main responsibilities include: Plan, develop, and take ownership in data-intensive investigations of financial fraud Conduct background research to develop hypotheses of where fraud occurs Write scripts to retrieve and organize data; parse free-form text fields, images, and spreadsheets to derive insights Construct and analyze large datasets to find fraudulent patterns; develop quantitative and empirical methods to detect where fraud occurs Summarize and present findings to technical and non-technical audiences Job Qualifications: Required Background in statistics, mathematics, engineering, computer science, data science, economics, or other quantitative field Demonstrated experience with R, Python, and/or SQL Attention to detail Intellectual curiosity and interest in fraud analysis Highest ethical standards Strong teamwork abilities Preferred 2+ years of relevant full-time experience. Excellent skills in R, Python, and/or SQL Knowledge of financial concepts and principles Demonstrated aptitude for research Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.

Integra FEC (Financial Economic Consulting) is a litigation and economic consulting firm that exists to restore integrity to the financial system through forensic data analytics. We work with government agencies and law firms in their efforts to combat a wide array of financial fraud, in areas ranging from securities to healthcare to crypto assets. We are looking for strong candidates with quantitative and financial backgrounds and a natural curiosity to learn to join our team and help tackle complex projects by efficiently analyzing data. Main responsibilities include: Plan, develop, and take ownership in data-intensive investigations related to financial fraud Write scripts to retrieve and organize data; parse free-form text fields, images, and spreadsheets to derive insights Construct and analyze large datasets to find fraudulent patterns; develop quantitative and empirical methods to analyze potentially fraudulent conduct Summarize and present findings to technical and non-technical audiences, through long-form reports, charts and slides Anticipated to grow toward managing projects and communicating with clients Job Qualifications Required 3+ years of relevant work experience Background in statistics, mathematics, engineering, computer science, data science, accounting, finance, economics, or other quantitative field Demonstrated experience with R, Python, and/or SQL Attention to detail Intellectual curiosity and interest in fraud analysis Highest ethical standards Strong teamwork abilities Preferred Excellent skills in R, Python, and/or SQL Background in economic/management consulting or finance Knowledge of financial concepts and principles Knowledge of crypto, decentralized finance, or smart contracts Demonstrated aptitude for research Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.

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. Position Summary The growing DSNP business has created an opportunity for an individual with claims experience, who is familiar with the 837 standard claims format. This individual will own 837 file transmissions to the states, manage and act on state response files, ensuring that all transactions transmitted are complete and error free. Manage and complete error corrections to meet state requirements. Required Qualifications 1&#43; year of experience with encounter data, medical claims, or Medicare/Medicaid. 1&#43; year of experience using FTP and data transfer software. 1&#43; year of data management experience. Preferred Qualifications Experience with Microsoft Access Databases. Analytical skills with the ability to identify and resolve data discrepancies. Working knowledge of the 837 claims files. Education Bachelors degree or equivalent work experience Anticipated Weekly Hours 40 Time Type Full time Pay Range <p s