Job Description
Job Description
The Business Data Coordinator is responsible for the operational development and performance of prior authorization criteria. Some of this includes: configuration data, clinical protocols, and medical notification documents within CVS Healths Medical Claims and Prior Authorization platform (Novologix). The position works closely with other business teams to manage scheduled and ad hoc projects for new implementation and maintenance of existing clients.
In order to be successful in this role you will analyze, build, update and test clinical criteria, system configuration, and medical notification documents to the specifications of individual client requirements. You will also identify and communicate details of system issues to proper team resource and track to resolution. You should communicate with and support internal and external clients through development, implementation, and maintenance of Novologix system enhancements and projects. The coordinator will participate in the implementation of new products and system enhancements by providing data and recommendations to assist in evaluating the impact of the proposed benefit, system, or process changes. Lastly you'll need to investigate and troubleshoot Novologix system incidents and assist clients in their resolution as related to prior authorization criteria and configuration set up.
This is a remote/ work from home position and we're looking for someone interested in working Monday through Friday from 8:00am - 5:00pm.
We offer a comprehensive benefits package which includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays.
Required Qualifications
3+ years of Data Analysis experience utilizing Excel (this includes reviewing reports and data entry)
Preferred Qualifications
- Experience working within a Medical Billing/ Medical Insurance environment.
- Familiar with State and Federal Pharmaceutical Regulations.
- Bachelors Degree within Arts or Science.
Education
High School Diploma or GED required
Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
The Business Data Coordinator is responsible for the operational development and performance of prior authorization criteria. Some of this includes: configuration data, clinical protocols, and medical notification documents within CVS Healths Medical Claims and Prior Authorization platform (Novologix). The position works closely with other business teams to manage scheduled and ad hoc projects for new implementation and maintenance of existing clients.
In order to be successful in this role you will analyze, build, update and test clinical criteria, system configuration, and medical notification documents to the specifications of individual client requirements. You will also identify and communicate details of system issues to proper team resource and track to resolution. You should communicate with and support internal and external clients through development, implementation, and maintenance of Novologix system enhancements and projects. The coordinator will participate in the implementation of new products and system enhancements by providing data and recommendations to assist in evaluating the impact of the proposed benefit, system, or process changes. Lastly you'll need to investigate and troubleshoot Novologix system incidents and assist clients in their resolution as related to prior authorization criteria and configuration set up.
This is a remote/ work from home position and we're looking for someone interested in working Monday through Friday from 8:00am - 5:00pm.
We offer a comprehensive benefits package which includes medical, dental, vision insurance as well as a wide-ranging list of supplemental benefits and discount programs. In addition to sixteen paid days off for employees, we also offer ten paid holidays.
Required Qualifications
3+ years of Data Analysis experience utilizing Excel (this includes reviewing reports and data entry)
Preferred Qualifications
- Experience working within a Medical Billing/ Medical Insurance environment.
- Familiar with State and Federal Pharmaceutical Regulations.
- Bachelors Degree within Arts or Science.
Education
High School Diploma or GED required
Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
14822267