Job Description This is a Scrum Team role that will be a member of the Medicare / Medicaid / Exchange Enrollment Configuration team tasked with developing purpose built capabilities for our NextGen platform.
This role is responsible for delivering configuration for various enrollment, billing, reconciliation, correspondence and reporting Stories within an Agile framework.
Performs analysis and translates business needs to create high-quality Business Requirements and Functional Specifications documentation within specified time frames to solve moderately complex problems (multiple interfaces with other systems within a business unit) considering all impacted components from an end-to-end perspective.
Performs data analytics using SQL / PLSQL at an intermediate level Ensures end-to-end traceability of requirements is complete.
Applies specific functional and/or business expertise to perform assigned tasks and develop specific project deliverables.
Conducts impact analysis of configuration changes on business processes and existing technology.
Competent to work with minimal supervision in a technical capacity on most phases of the business systems analysis.
Contributes to the review of Test Planning and Test Execution strategies.
Develops business workflow diagrams.
Assists in the development of data models and interface design specifications.
Documents, tracks, and resolves issues related to data quality.
Contributes to the design and mapping of data conversion strategies.
Participates in collaborative system and data design sessions with the user community, technical architecture resources, and development resources.
Completes project activities on time and within budget, and proactively identifies and communicates issues that may jeopardize milestones or project budget to the Project Manager / Product Owner.
Adheres to SDLC or AGILE project management methodology by utilizing internal procedures and tools and identifying areas for methodology improvement.
Develops Product Overviews, FAQs, Tool Glossaries, system training material, and system user documentation to support implementation activities.
Creates appropriate communication materials are documented and distributed appropriately.
Conducts interviews, fact-finding, and independent research to design creative, progressive solutions for business problems.
Required Qualifications Experience PLSQL / Oracle databases; Intermediate to Advanced (2-4 years) Experience with software development lifecycles, having owned: detailed analysis (data / process analytics, process improvements, process flow creation, requirements gathering, requirements traceability through the software delivery lifecycle, including post-production checkout / reviews.
(4-6 years) Experience with extensive analytical techniques (Scenarios and Use-cases, Scope Modeling, Functional Decomposition, Interviews, Observation / Job Shadowing, Focus Groups, Acceptance and Evaluation, Sequence Diagrams, User Stories, Brainstorming, Storyboarding, Prototyping, Event Analysis, Business Rule Analysis, Requirements Workshops, Risk Analysis, Root Cause Analysis) (4-6 years) COVID Requirements 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.
Preferred Qualifications Experience with the MHK Market Prominence platform and / or the HealthEdge Health Rules Payor platform Experience with software development lifecycles, having contributed to: estimation (resource planning), capacity planning, requirement gathering, testing framework and strategy, and post implementation review.
(4-6 years) Experience with member materials / correspondence implementation experience (2-4 years) Experience with Medicare, Medicaid or Exchange Enrollment, Billing and Correspondence Operations (2-4 years) Leadership / Creating Accountability (Intermediate) Leadership / Developing and Executing Strategy (Intermediate) Leadership / Driving a Culture of Compliance (Foundational) General Business Consulting for Solutions (Advanced) Leadership / Anticipating and Innovating (Advanced) Technology / Justifying the Business Case (Advanced) Experience with enterprise-wide and / or cross-functional large scale initiatives with high degree of complexity.
Demonstrated experience successfully implementing change in complex organizations Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.
Education Bachelor’s degree or equivalent experience 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.