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Senior Analyst, Provider Relations (Metro NY) at CVS Health - ApplyBlast

Senior Analyst, Provider Relations (Metro NY)

CVS Health

4 months ago

3.2 on Glassdoor

Remote

Full Time

Junior

1 applicant

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About this role

This role manages complex provider-facing workflows, inquiries, and escalations across claims, enrollment, contracting, and regulatory functions at CVS Health. Serving as a key liaison between healthcare providers and internal operations, the position requires strong analytical capabilities to investigate issues, drive resolutions, and ensure compliance with regulatory and network requirements.

Responsibilities

Manage complex provider inquiries and escalations across claims and enrollment domains
Investigate and resolve provider disputes involving medical denied claims and policy issues
Coordinate provider contract adjustment requests and termination appeals with contracting teams
Facilitate HIPAA-related updates and support fraud waste abuse investigation efforts
Analyze operational data trends to identify process improvement opportunities and recurring issues

Skills

About CVS Health

cvshealth.com

Headquarters

Woonsocket, Rhode Island, United States

Company Size

10001+ employees

Founded

1963

View Profile

CVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.