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
Lead a team of Medicaid Provider Data Services Analyst responsible for loading and maintaining Medicaid Provider data within Aetna QNXT.
Team will also include provider operations analyst and pre-cred support for implementation activities.
Provides assistance and support to other departments, as needed, to obtain crucial or required information from Providers, such as HEDIS, Credentialing, Grievance and Appeals, SIU, etc.
Coordinates provider status information with member services and other internal departments.
Monitor Provider Data pends and keep inventory w/in KPIs and/or Metrics
Recruits, develops, and motivates staff. Initiates and communicates a variety of personnel actions including, employment, termination, performance reviews, salary reviews, and disciplinary actions.
Monitors staff performance, including weekly staff metrics;
Required Qualifications
3+ years recent and related experience in Provider Operations, Provider Relations or Network operations.
1+ years of experience in Medicaid and/or Medicare provider operations.
2+ year of experience with ensuring the provider data entered into the provider database is accurate and the provider documentation is complete and accurate
3+ years of experience in managing, coaching, and leading a team
3+ years of experience supervising or managing a production oriented team.
Preferred Qualifications
Strong collaboration skills
Medicaid new state or expansion experience
Strong reporting and data analysis skills and experience
Ability to load balance and prioritize work in order to meet key performance metrics around TAT and quality
Drive and oversee productivity of staff
Experience with new Medicaid state implementation related to provider requirements.
Leadership skills including staff development
Critical thinking and problem solving skills
Familiarity with Provider Data/Enterprise systems
Strong skills in Microsoft products
QuickBase knowledge
Education
Bachelor's degree or equivalent professional work experience.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$66,330.00 - $145,860.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 03/07/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.