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Position Summary

This is a highly collaborative position that often requires managing relationship across departments or multiple functional areas.

• Supports the Aetna Better Health of Kansas Medicaid Plan by overseeing the performance of subcontractors serving Aetna Medicaid members throughout the state.- Develops and maintains strong relationships with subcontractor leadership teams and managers, ensuring that contractual requirements are met or exceeded.

• Researches and provides education on claims adjudication and Kansas State Medicaid policy-alignment.- Ensures appropriate prioritization of State and Plan inquiries to ensure exceptional customer services is provided to our members and providers- Recommends appropriate actions, strategies and/or alternatives to meet business needs.- Responsible for all aspects of project/program management, such as planning, coordination, development, and implementation; including the financial implications while prioritizing work, resources and time.- Certifies the end state of the project and/or business operations meets business objective(s) and that all deliverables and due dates are met.- Interacts directly with government officials and advises of project status.- Reviews claims/encounters and completes projects as appropriate.- Interprets claims guidance and/or policies and is responsible for success implementation.- Supports and assists with additional operational activities, as needed. Required Qualifications

  • 3-5 years of relationship management experience- 3-5 years of Medicaid experience- 3-5 project/program management experience

  • 3-5 years of claims experience- Strong verbal and written communication and interpersonal skills

Preferred Qualifications- 3-5 years of direct regulatory communication experience

Pay Range

The typical pay range for this role is:

$67,900.00 - $170,800.00

This 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. This position also includes an award target in the company’s equity award program. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

CVS Health requires certain colleagues 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, religious belief, or other legally recognized reasons that prevents them from being 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 or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health colleagues can initiate a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through myHR (1-888-694-7287, or through myLeave at myHR). If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.