Senior Project Manager - Medicaid Provider Operations &...

Job DescriptionDo you want to make a large impact in your next role? Join Aetna/CVS Health, as the Senior Project Manager of Medicaid Provider Operations and Support, where you will be the project management lead for our Provider Operations, PDS and Medicaid Pre-Credentialing. We are looking for a seasoned Project Manager that will focus on the collaboration and sharing of best practices for improved provider data as well as managing all provider data initiatives. In this role, you will have the opportunity to lead highly visible projects across a complex and matrixed team, developing executive presentations and collaborating with senior leadership.You will accomplish this through:- Collaboration of cross-functional teams for the implementation of provider data projects, managing initiatives with the Medicaid network and local health plans. - Provide guidance and project support on best practices for data improvement and quality across several departments. - Internally supports and contributes to improved provider data by handling standard problems regarding policies and procedures, credentialing process, audits and vendor tasks. - Assists with operational activities that may include, but are not limited to, data reporting, data research, and systems updates - Working knowledge of business segment specific codes, products, and terminology.To be successful, you will utilize your strong understanding of provider data and Aetna systems, combined with your superb communication and prioritization skills to meet project deadlines.This is a fully remote position that can be located anywhere in the U.S.Pay RangeThe typical pay range for this role is:Minimum: 75,400Maximum: 158,300Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications- 7 years of work experience (graduate education may substitute) including:- 5+ years related work experience in provider data, provider relations, provider network or provider operations- 5+ years experience in formal project management- Strong excel skills and working knowledge of Quickbase and Microsoft teams and Share Point.- Workflow management experience and Visio knowledgeCOVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues 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, religious belief, or other legally recognized reasons that prevents them from being 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 or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications- Technology Experience with QNXT, Remedy, EPDB, Smart Front End, PRMS and directories strongly preferred- Experience driving change and turning data into informationEducationBachelor's degree or equivalent experienceBusiness OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2025-11-15