Disputes Delivery Lead

CVS Health Job Opportunity

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.

A Brief Overview

This is an individual contributor role within the Provider Digital Operations Portal team that will oversee the planning, coordination, and implementation of the enhancements to the provider dispute process within the Availity portal across all lines of business. This role partners with IT, operations, network teams, and Availity to drive improvements and enhance the provider experience. Responsibilities include gathering business requirements, managing cross functional initiatives, tracking project milestones, support deployment activities and ensuring changes are communicated effectively to stakeholders and end users.

What You Will Do

• Directs the day-to-day complex business consulting operations to support the organization's goals and objectives.
• Administers processes and assignments for research, collecting, analyzing, and compiling data and information for the business consulting department reports.
• Handles files, reports, and financial records, and manages department record retention.
• Leads individuals to develop a high degree of customer service by fielding internal and external inquiries, finding resolutions, or redirecting as appropriate.
• Collaborates internally and externally with clients and senior management regarding the organization's goals and objectives.
• Advises the internal and external department point of contact ensuring concise communication with employees, stakeholders, and members of the senior management.
• Develops reports for the organization regarding current business trends and best practices preparing analysis for senior management, stakeholders, and clients.
• Authorizes processes for performance appraisals within the business consulting department ensuring compliance and continuous improvement.
• Evaluates performance through regular, timely feedback to ensure delivery of exceptional services and engagement, motivation, and team development.

Minimum Requirements

• 5+ years of experience in healthcare operations, provider disputes, claims management, or process improvement leadership.
• Knowledge of provider dispute and appeals workflows preferably across multiple lines of business.
• Experience managing cross functional projects involving business, operational, and technical stakeholders.
• Familiarity with provider portal platforms such as Availity.
• Familiarity with healthcare transaction standard processes.
• Strong analytical communication and organizational skills with the ability to manage multiple priorities, drive process enhancements, and support change management.

Education

• Bachelor's degree preferred/specialized training/relevant professional qualification.

Pay Range

The typical pay range for this role is: $82,940.00 - $199,144.00. 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.

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.