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At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary The Network Relations Sr Analyst supports our Medicaid Provider Experience programs to maintain provider risk management and positive relationships supporting high value initiative activities with our Provider network. The Network Relations Sr Analyst will assist in driving coordination of internal and external solutions to achieve Best-in-Class provider satisfaction, affordability and quality improvements as set by each Medicaid Health Plan.<ul> <li>Deploy and support the Medicaid Provider Engagement program including onsite meetings at Aetna offices as required</li> <li>Reviews, learns and participates with operations teams regarding policy and procedures related to claims/providers.</li> <li>Assist with the monitoring of executed provider contracts to ensure Network Access meets State requirements</li> <li>Coordinates provider information with Provider Data Services including Member Services and other internal departments as requested as Provider Demographics are updated</li> <li>Supports providers by resolving problems and advising providers of new protocols, policies, and procedures</li> <li>Deliver training materials for staff and provider network. Participates as need for initial and ongoing provider in-services and provider education. </li> <li>Participates, when requested, in Grievance and Appeals meetings, and/or assists with tracking and trending provider grievances,</li> <li>Assists as requested for responses for all governmental, regulatory and quality assurance provider complaints; timely and continuous reconciliation of provider records; oversees Provider Access and Availability by reviewing Appointment Availability Audits conducted by staff</li> <li>Provides support and maintenance assistance for websites, portals, directories, manuals, and dashboards; plans, coordinates, and conducts provider forums and monthly webinars; develops communications including newsletters</li> <li>Provides assistance and support to other departments, as needed, to obtain crucial or required information from Providers, such as HEDIS, Credentialing, Grievance and Appeals, SIU, etc. Coordinates provider status information with member services and other internal department</li> <li>Promotes and educate providers on cultural competency</li> </ul> Required Qualifications<ul> <li>Minimum of 3 to 5 years’ experience in Provider Relations; experience in Medicaid servicing or managing non-standard relationships with providers with exposure to benefit plan design and/or contract interpretation</li> <li>Excellent interpersonal skills and the ability to work with others at all levels </li> <li>Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claims Processing, Provider Appeals &amp; Disputes and Network Performance Standards</li> <li>Excellent problem-solving skills</li> <li>Strong communication skills</li> <li>Candidates are to reside within applicable state with ability to travel as needed to provider sites and Aetna office locations as required</li> </ul> EducationBachelor’s degree or an equivalent combination of formal education and experienceAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$46,988.00 - $122,400.00This 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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 07/02/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Senior Analyst, Network Relations

Job Description: At Bank of America, we are guided by a common purpose to help make financial lives better through the power of every connection. We do this by driving Responsible Growth and delivering for our clients, teammates, communities and shareholders every day. Being a Great Place to Work is core to how we drive Responsible Growth. This includes our commitment to being a diverse and inclusive workplace, attracting and developing exceptional talent, supporting our teammates’ physical, emotional, and financial wellness, recognizing and rewarding performance, and how we make an impact in the communities we serve. Bank of America is committed to an in-office culture with specific requirements for office-based attendance and which allows for an appropriate level of flexibility for our teammates and businesses based on role-specific considerations. At Bank of America, you can build a successful career with opportunities to learn, grow, and make an impact. Join us! About the Team: The Global Technology Service Management function is a new team charted with designing, implementing and managing next generation Service Management policies, processes and solutions. Our mission is to ensure the appropriate controls and capabilities are in place to enable the delivery of stable, resilient, and available technology services to our customers and employees. Job Description: The Senior ServiceNow Data Architect is responsible for defining an architectural vision and solution that supports the strategic outcomes of our Service Management function. Key responsibilities include defining the target operating environment, designing for client resiliency, assisting with solution design, and defining non-functional requirements. Job expectations include working with stakeholders and service providers aligned to the Business' strategic objectives, evaluating the impact of strategic design decisions, and contributing to the architecture roadmap. Position Summary: Design &amp; Architecture: <ul> <li>Design scalable, secure, and high-performing data models that are aligned to ServiceNow platform and industry data requirements</li> <li>Collaborate with platform architecture, business and partner teams to understand business requirements and translate them into data architecture solutions</li> <li>Develop data strategies for integrating ServiceNow with other enterprise systems and databases for the purposes of sourcing data and consuming data from ServiceNow</li> <li>Design data governance policies, including data quality, data security, and compliance standards</li> <li>Design and implement reporting strategy for meeting operational, business and regulatory requirements using ServiceNow, data warehouses and reporting platforms</li> </ul> Data Modeling: <ul> <li>Design logical and physical data models for ServiceNow applications and modules, ensuring alignment with industry leading practices</li> <li>Optimize data structures for efficient storage, retrieval, and reporting</li> <li>Publish and maintain data model documentation and library for consumption by integration partners and various service management processes</li> </ul> Data Integration &amp; ETL: <ul> <li>Design and implement ETL (Extract, Transform, Load) processes for integrating ServiceNow with third-party applications, databases, and systems</li> <li>Ensure smooth data flow and ensure that data integration processes are efficient and maintainable</li> </ul> Reporting &amp; Analytics: <ul> <li>Collaborate with data analysts and business intelligence teams to define reporting requirements and design data models that support actionable insights</li> <li>Create dashboards, reports, and analytical views using ServiceNow's reporting tools and third-party tools</li> <li>Develop reporting strategy to provide visibility of data flow from sourcing to consumption including frequency, mapping, transformation and translation of data elements</li> </ul> Collaboration &amp; Stakeholder Management: <ul> <li>Work closely with developers, project managers, business analysts, and other IT teams to ensure alignment and successful delivery of data-driven solutions</li> <li>Provide expert guidance on data-related issues and ensure that ServiceNow data architecture supports long-term business goals</li> </ul> Performance &amp; Optimization: <ul> <li>Continuously monitor data architecture performance and provide recommendations for optimization</li> <li>Develop and implement process to detect data variances and implement corrective actions</li> <li>Resolve data-related issues and troubleshoot performance bottlenecks within the ServiceNow platform</li> </ul> Responsibilities: <ul> <li>Works across the business, operations and technology to create the solution intent and architectural vision for complex solutions and prioritize functional and non-functional requirements into a technology backlog to enable the technology roadmap and functionality to support evolving capabilities and services</li> <li>Contributes to the creation of the architecture roadmap of defined domains (Business, Application, Data, and Technology) in support of the product roadmap and the development of best practices including standardized templates</li> <li>Clarifies the architecture, assists with system design to support implementation, and provides solution options to resolve any architectural impediments</li> <li>Facilitates solution driven discussions, leads the design of complex architectures, and finds creative solutions through knowledge of domain, practical experiments, and proof of concepts while ensuring architecture is flexible, modular, and adaptable</li> <li>Educates team members on the technology practices, standardization strategies, and best practices to create innovative solutions</li> <li>Supports the team as needed to select the technology stack required for solutions and helps select preferred technology products</li> <li>Performs design and code reviews to ensure all non-functional requirements are sufficiently met (for example, security, performance, maintainability, scalability, usability, and reliability)</li> </ul> Required Qualifications: <ul> <li>5-8 years of experience in data architecture, with at least 3-5 years of hands-on experience specifically with ServiceNow</li> <li>Strong experience in data modeling, database design, and management of data systems</li> <li>Proficient in ServiceNow data schema and architecture, including tables, fields, and relationships</li> <li>Expertise in ServiceNow IntegrationHub, REST, SOAP APIs, and other integration tools</li> <li>Solid knowledge of relational databases (e.g., MySQL, MS SQL) and NoSQL databases.</li> <li>Experience with enterprise data warehouse, reporting and visualization solutions (e.g. Snowflake, Teradata, Tableau)</li> <li>Familiarity with ServiceNow modules like ITSM, ITOM, and HR Service Delivery</li> <li>Strong understanding of data governance, data privacy, and security protocols</li> <li>Strong knowledge of data quality, correctness and completeness related metrics and controls</li> <li>Knowledge of industry best practices for data management and integration</li> <li>Excellent problem-solving and analytical abilities to troubleshoot data issues and implement effective solutions</li> <li>Strong verbal and written communication skills, with the ability to work effectively with both technical and non-technical stakeholders</li> <li>Ability to lead and mentor junior team members</li> </ul> Desired Qualifications: <ul> <li>ServiceNow Certified System Administrator (CSA) and/or Certified Implementation Specialist (CIS) certifications</li> <li>Experience with ServiceNow Performance Analytics or other BI/analytics platforms</li> <li>Familiarity with Agile/Scrum development methodologies</li> </ul> Skills: <ul> <li>Analytical Thinking</li> <li>Architecture</li> <li>Result Orientation</li> <li>Solution Design</li> <li>Technical Strategy Development</li> <li>Application Development</li> <li>Collaboration</li> <li>Data Management</li> <li>DevOps Practices</li> <li>Risk Management</li> <li>Agile Practices</li> <li>Automation</li> <li>Influence</li> <li>Solution Delivery Process</li> <li>Test Engineering</li> </ul> Shift:1st shift (United States of America) Hours Per Week: 40

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