FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Senior Analyst, Financial Operations – PDE Reporting
CVS Health. Review claims and PDE (Prescription Drug Event) errors .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in analyzing and improving Medicare claims data, ensuring compliance with CMS guidance, and effectively communicating with internal and external stakeholders. Proficient in managing multiple projects while utilizing SQL and Python for data analysis.
Highest-signal resume keywords
Medicare Claims Data AnalysisCMS ComplianceSQL ProficiencyPython ProficiencyGovernment-Regulated Health Programs Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ReviewPDE Error AnalysisRoot Cause AnalysisData InterpretationPDE ReportingFinancial OperationsPart D Plans KnowledgeAcumen Outliers Review
Soft Skills
Excellent Written CommunicationExcellent Verbal CommunicationStrong Organizational SkillsTime Management
Tools & Technologies
Microsoft WordMicrosoft Excel
Industry Keywords
CMS GuidanceMedicaidMedicarePDE RejectionsHealth Programs
Tech Stack
Tools & technologiesPythonSQL
About the role
Key responsibilities & impact- Review claims and PDE (Prescription Drug Event) errors
- Analyze and distribute PDE Rejections reports and analysis to internal and external clients
- Serve as liaison between the PDE Reporting Team, PDE Eligibility/Reconciliation, and entities involved with PDE
- Download and review Acumen Outliers
- Coordinate research with various departments
- Submit responses to external clients or Acumen according to CMS deadlines
- Assist with weekly PDE meetings
- Ensure continuous improvement of Medicare claims data through root cause and impact analysis of errors
- Recommend systems and procedure enhancements
- Review guidance and ensure compliance with CMS
Requirements
What you’ll need- Minimum 3 years of experience with government-regulated health programs within financial operations and/or related experience, including Medicaid, Medicare, and/or Exchanges
- Working knowledge of Part D plans
- Ability to study and correctly interpret CMS Guidance
- Compliance with CMS guidance
- Excellent written and verbal communication skills
- Strong organizational skills and ability to manage multiple projects simultaneously
- Excellent time management skills
- Proficiency with Microsoft Word and Excel
- Proficiency with SQL and/or Python
- Bachelor's degree preferred or equivalent work experience required
Benefits
Comp & perks- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
- CVS Health bonus, commission or short-term incentive program eligibility