Job Description
Job Description
The dedication of talented and caring health care professionals drives the delivery of high quality, cost effective products and services. They make it possible for members to get the right health care treatment for their needs - and for Aetna to keep its competitive edge.
Resolves high volume/high impact systemic problems through proactive and reactive mechanisms (e.g. automation, route audit programs, data
reporting, root cause analysis).
Required Qualifications
Identifies, researches and conducts root cause analyses (e.g. problem providers identified by PST, trends from routine PDS audits) and recommends process improvements
Creates and manages action plans for assigned projects relative to data quality and/or workflow improvements. Ensures that all impacted constituents are considered and appropriately addressed in action plans
Conducts and manages on-going system audits of provider data services
Provides issue resolution and complex trouble shooting, including monitoring outcomes
Works cross-functionally throughout the organization in issue/problem identification and resolution
Preferred Qualifications
Experience and knowledge of PDS systems and other end user applications
Education
Bachelor's degree or equivalent and 3+ years of relevant experience
preferred.
Business Overview
At Aetna, a CVS Health company, 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 dedication of talented and caring health care professionals drives the delivery of high quality, cost effective products and services. They make it possible for members to get the right health care treatment for their needs - and for Aetna to keep its competitive edge.
Resolves high volume/high impact systemic problems through proactive and reactive mechanisms (e.g. automation, route audit programs, data
reporting, root cause analysis).
Required Qualifications
Identifies, researches and conducts root cause analyses (e.g. problem providers identified by PST, trends from routine PDS audits) and recommends process improvements
Creates and manages action plans for assigned projects relative to data quality and/or workflow improvements. Ensures that all impacted constituents are considered and appropriately addressed in action plans
Conducts and manages on-going system audits of provider data services
Provides issue resolution and complex trouble shooting, including monitoring outcomes
Works cross-functionally throughout the organization in issue/problem identification and resolution
Preferred Qualifications
Experience and knowledge of PDS systems and other end user applications
Education
Bachelor's degree or equivalent and 3+ years of relevant experience
preferred.
Business Overview
At Aetna, a CVS Health company, 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 are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. 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.
67537398