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
We are excited to invite a highly motivated and detail-oriented Project Manager to join our team. The Project Manager will be part of the Network Platform Solutions – Contracts & Pricing Team to support Strategic Pricer IT projects. In this role, you will research and analyze Strategic Pricer functionality and enhancements for participating providers. This position offers a valuable opportunity for personal and professional growth, as you will play a key role in successfully delivering and executing enhancements while collaborating with various business partners.
Responsibilities include:
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Serve as a subject matter expert for Strategic Pricer
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Evaluates combinations of rate drivers and payment methods in the Rate Wizard applying Strategic Pricer concepts, to predict outcomes
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Contribute to maintenance of team training materials, including formulation of contract and/or claim examples, system mock-ups, and depiction of pricing outcomes
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Support other business initiatives and system projects as required
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Collaborate with cross-functional teams to ensure effective implementation of project objectives
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Monitor project progress and report on key metrics
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Facilitate meetings and discussions to gather feedback and drive project improvements
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Research and analyze claim inquiries regarding accuracy of Strategic Pricer and/or identify contract input errors
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Contracted Service Grouping Maintenance & coordination
Required Qualifications
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Strong problem-solving and decision-making skills.
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2 to 3 years project management experience
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5 to 7 years healthcare insurance experience
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Strong analytical skills and attention to detail.
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Excellent communication and collaboration skills.
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Ability to adapt to changing priorities and work effectively under pressure.
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Demonstrated ability to learn new concepts
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Demonstrated ability to successfully deliver assigned projects
Preferred Qualifications
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Demonstrated proficiency with Strategic Pricer logic and concepts
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Proficiency with SCM Rate Wizard input including non-preferred contracting options
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2 to 3 years claims processing experience
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Working knowledge of EPDB
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Intermediate SCSR knowledge
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Proficiency in Microsoft: Excel, Word, and Teams
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ACAS claims participating provider knowledge a plus
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Familiarity with the various CMS payment methodologies supported by Strategic Pricer via Burgess software
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QuickBase and SharePoint user experience
Education
Bachelor's Degree or equivalent experience
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$54,300.00 - $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:
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Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
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No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
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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: 05/30/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
