Manager, Business Consultant - Revenue Integrity

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

Reporting to the Lead Director of ACA Revenue Integrity, the Senior Consultant, will work closely with various RI Lead Directors and subject matter experts across the ACA Individual (IFP) business to establish and champion market level revenue integrity excellence. This position is responsible for supporting all assigned market level risk adjustment activities and processes related to complete and accurate diagnosis capture through provider and member engagement.  In support of the RI IFP Performance Management Office this position will:

• Own, maintain, and develop IFP PMO performance reporting and related artifacts.

• Collaborate cross functionally to support and maintain IFP PMO goal setting and budget/forecast processes.
• Assemble and analyze data to produce ACA dashboard reporting specific to ACA-IFP Revenue Integrity efforts for various governance, market, and executive leadership meetings.
• Generate/maintain other reporting as required.
• Support other RI ACA initiatives as required.

Required Skills and Qualifications

• 5+ years of experience in healthcare
• Proven ability to manage multiple projects simultaneously and meet deadlines.
• Strong analytical and problem-solving skills
• Strong excel skills
• Excellent communication, presentation, and writing skills.
• Highly organized with excellent attention to detail

Preferred Skills and Qualifications

• Experience with risk adjustment, preferably ACA risk adjustment
• Experience in project management
• Some finance and budgeting experience a plus

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$66,330.00 - $145,860.00

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 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:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• 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.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 04/19/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.