CVS Health Job - 39445546 | CareerArc
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Company: CVS Health
Location: Minneapolis, MN
Career Level: Associate
Industries: Retail, Wholesale, Apparel


Job Description
This position will support the Allina Health | Aetna joint venture Medicare team as a local resource accountable for ensuring provider relationships perform optimally with regards to RAF, documentation and specificity. They will be tasked to:

- Support holistic solutions and/or key strategic plans
- Work across local market leadership to establish and champion a local market culture committed to RAF excellence
- Act as the face of Revenue Integrity externally with providers and manage internal and external stakeholder relationships critical to the RI environment
- Identify and execute upon local market RAF strategies
- Drive key initiatives and transfer knowledge, best practices, methodology and tools to stakeholders
- Manage and direct local vendors when appropriate
- Conduct data analysis using national tools in conjunction with the corporate lead to identify opportunity areas and paths on track; assure member metrics met
- Jointly identify VBCs/non-VBCs to prioritize with RAF initiatives; develop strategy on which members/VBCs/providers get embedded coder training
- Engage with clinical team and specific clinics, medical groups, hospitals; attend JOC meetings and facilitate work sessions; support engagement managers and RN program managers using a disciplined repeatable methodology
- Support local market colleagues in ensuring strategic and optimal bids; attend/host trainings
- Partner closely with segment STARs, MSO, product, sales, network, clinical, and MEU
- Share joint accountability for initiative return on investment
- Develop and deliver required analysis, reporting and presentation materials

Required Qualifications
- Experience with Microsoft Office products (Word, Excel, Project, PowerPoint, Outlook)
- Experience with ICD-10 codes
- Experience with Medicare and/or Medicaid Risk Adjustment process
- Experience with moderate scale initiatives with moderate degree of complexity

Preferred Qualifications
- Minimum of 4 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing
-CPC (Certified Professional Coder) or CRC (Certified Risk Coder) Highly Preferred
- Excellent analytical and problem solving skills, including data analysis and packaging
- Effective communications, organizational, and interpersonal skills
- Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels

College degree or equivalent experience. Master's degree 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.

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