Experience desired: Proven track record of completing tasks accurately and timelyHistory of leading a high functioning team focused on results and collaborationAbility to collaborate with all levels of staff and management with focus on education and process improvementResearch and resolution of issuesTime management to complete work according to documented service level agreementsPrevious experience with QNXT claim and configuration review and strong understanding of modules associated with claim paymentsAbility to interpret State and Health Plan source documentation and understanding of its relation to internal documentation and QNXT outputDefine, develop and maintain test scripts to ensure product testing is complete and high quality prior to sign offParticipates in test plan/test cases/test walkthroughs with SMEs to understand testing to be completedValidates actual results of testing vs expected results and proactively reports issues, problems or delays in testing Functional and Technical Experience:Claim - Claim processing - Medicaid and MedicareClaim - Policies & proceduresCommunication - Management: Management - Management - SystemsAetna Application - QNXTDatabase - Microsoft SQL ServerDesktop Tool - Microsoft ExcelDesktop Tool - Microsoft WordDesktop Tool - Microsoft Outlook Skills:Leadership - Anticipating and InnovatingLeadership - Collaborating for ResultsGeneral Business - Communicating for ImpactGeneral Business - Demonstrating Business and Industry AcumenTechnology - Creating Technology Partnerships
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
- If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
- If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.
Please review required qualifications above
High School diploma, G.E.D. or equivalent experience
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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