Lead Director, Business Consultant

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.

Position Summary

Designs enterprise-wide and/or cross-functional solutions to address business problems. This work results in initiatives that significantly impact organizational strategy, enabling the organization to be competitive in the marketplace and effectively serve its customers. Partners with business owners to optimize the achievement of strategic business objectives, to include profitable growth and improved organizational effectiveness.
What you will do
Advises management through strategic business consultation to support the organization's goals and objectives.

Develops standard procedures related to researching, collecting, analyzing, and compiling data and information for business consulting department reports.

Develops and implements processes for auditing files, reports, and financial records ensuring compliance with relevant laws and regulations.

Communicates with top management to lead individuals to develop a high degree of customer service by fielding internal and external inquiries, finding resolutions, or redirecting as appropriate.

Communicates strategically internally and externally with clients and senior management regarding the organization's goals and objectives.

Counsels the internal and external department point of contact ensuring concise communication with employees, stakeholders, and members of the senior management.

Advises management regarding current business trends and best practices preparing analysis for senior management, stakeholders, and clients.

Controls all systems 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.

Required Qualifications

10+ years work experience in Healthcare Insurance Operations
Mastery of problem solving and decision making skills 

Mastery of collaboration and teamwork 

Mastery of execution and delivery (planning, delivering, and supporting) skills 

Strong SQL Development Skills, Report Development Skills in Power BI and Tableau

Ability to bridge communication gaps between business and IT partners.

Preferred Qualifications

WEDI X12/837I/837P EDI Gateway Processing, Editing and Mapping

Clean Claim Edits

Medicaid Risk Adjustment Strategy

Process Flow and Project Management

Education

4 year degree or equivalent business experience

Pay Range

The typical pay range for this role is:

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.  This position also includes an award target in the company’s equity award program. 
 

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.

Additional details about available benefits are provided during the application process and on Benefits Moments.

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