Job Closed
This listing is no longer active.
Bringing our heart to every moment of your health.
Manager, Claims Technical Analyst – Medicaid Intake Operations
Location
Arizona
Posted
57 days ago
Salary
$60.3K - $132.6K / year
Seniority
Senior
Job Description
Manager, Claims Technical Analyst – Medicaid Intake Operations
CVS Health
• Serve as the Technical Subject Matter Expert (SME) for intake rules and matching logic • Liaise with providers and internal teams to resolve questions about EDI and Claims Intake rejections • Provide second-level expert support for intake claim rejections • Analyze large datasets for research and troubleshooting • Collaborate with Product Owners and IT teams on system enhancements and fixes • Participate in testing and verification of business rules and validations • Manage multiple projects and tasks simultaneously while maintaining high-quality results • Support Product Owners, Business Owners, and Leads using technical and analytical expertise • Communicate effectively across all levels of the organization, including cross-functional teams • Write complex SQL queries to join multiple data sources and analyze data for root causes, trends, and opportunities • Lead the creation of automated reporting solutions using Tableau, Excel, and other tools to deliver actionable insights • Translate complex data analysis into clear, actionable information for non-technical audiences • Analyze EDI and Claims intake rejections from internal and external inquiries, including provider calls • Track and execute solutions for identified issues • Perform User Acceptance Testing for logic changes and enhancements • Develop utilities, queries, and processes for post-production checkout of business rules and system fixes
Job Requirements
- 3–5 years of experience as a SQL Server power user (coding and developing data extracts)
- 5+ years of data interpretation and analysis experience
- 4+ years working with data visualization tools (Tableau, Power BI, or equivalent)
- expertise in data storytelling and preparing data for presentation in Excel and PowerPoint
- 5+ years querying large datasets using SQL, SAS, or other data tools
- strong documentation skills; writes readable and reproducible code
- proficient in Word, PowerPoint, Excel
- self-starter with the ability to work independently and prioritize multiple deliverables
- demonstrated ability to manage conflicting priorities and concurrent projects
- excellent verbal and written communication skills, able to communicate technical ideas to non-technical audiences
- strong problem-solving, analytical, and critical thinking skills
Benefits
- medical, dental, and vision coverage
- paid time off
- retirement savings options
- wellness programs
- other resources, based on eligibility
Related Guides
Related Categories
Related Job Pages
More Support Engineer Jobs
Cyber Technician ll
Deep SeasThis is your chance to join a supportive crew of teammates and an industry-leading organization that values opportunities for growth. If DeepSeas sounds like a good fit for you, send us your resume and let’s talk!
Cyber Technician ll Department: TOC Employment Type: Full Time Location: Costa Rica Description Cyber Security Technicians provide skilled execution of technical operations and procedures. They bring a detailed and diligent approach to executing the daily activities of the organization. As members of the Technology Operations Center, they will play a crucial role in providing the technical skills to maximize the effectiveness of our clients’ cyber technology. **Remote role but MUST be able to work until 6pm pdt/9pm edt*** *Must be based in Costa Rica* Key Responsibilities - Cyber Tools Management – Work under subject matter experts to learn and understand the use and operation of the cyber tools used by our clients. Gain technical expertise on the deployment, configuration, and operation of those cyber tools. Execute advanced procedures using process documentation and SOPs and utilize vendor documentation and training to perform additional complex tool configuration tasks. - Operational Focus and Mindset – Be prepared to work in a mission-oriented operations team. Act with a sense of urgency and importance. Be vigilant and diligent to ensure constant high quality. Know and deliver high quality work with minimal supervision. - Platform Integration – Support clients in integrating with the DeepSeas platform. Follow standard operating procedures and aid clients in the onboarding process. - Monitoring and Response – Utilize the team’s tools and processes to monitor our clients’ cyber tools and respond to potential issues rapidly. - Documentation and Training – Contribute to the team’s established documentation and SOPs to adapt to evolving tools and processes. - Training and Continuous Improvement – Attend training sessions to improve the capabilities of the team. Skills, Knowledge and Expertise - Proven experience in delivering technical missions in a cybersecurity environment. Minimum 2 years of experience. - Proven ability to comprehend and execute documented processes. - Demonstrated ability to adapt to unknown issues with processes. - Demonstrated ability to troubleshoot and resolve moderately complex technical issues. - Excellent verbal and written communication skills. - Phone support experience is preferred. Benefits At DeepSeas, we like to say that heart rates go down, careers take off, and security programs mature. Our values provide the ultimate guide for our daily behavior and decisions. Without these values, we aren’t DeepSeas. They preserve the essence of our organization, reflect the personalities of our Deeps (how we affectionately refer to our teammates), and enable us to exceed expectations. Our values are: · We are client obsessed. · We stand in solidarity with our teammates. · We prioritize personal health and well-being. · We believe in the power of diversity. · We solve hard problems at the speed of cyber. This is your chance to join a supportive crew of teammates and an industry-leading organization that values opportunities for growth. If DeepSeas sounds like a good fit for you, send us your resume and let’s talk! Information security is everyone’s responsibility: · Understanding and following DeepSeas’s information security policies and procedures. · Remaining vigilant and reporting any suspicious activity or possible weaknesses in DeepSeas’s information security. · Actively participating in DeepSeas’s efforts to maintain and improve information security. · DeepSeas considers this position is as Moderate Risk with a potential to view/access/download restricted/private client/internal data. This information must be treated with sensitivity and in the most secure manner. · HR reserves the right to perform random background/drug screens to ensure the safety of client/DeepSeas data
• Lead the strategic evolution of Ashby’s Support Engineering function. • Define how technical support operates at scale. • Partner closely with Engineering leadership to improve how technical issues are surfaced, investigated, and resolved. • Drive alignment on escalation pathways, debugging expectations, and response patterns for complex customer issues. • Analyze patterns in escalations, bugs, and technical customer friction to identify systemic improvements. • Develop frameworks for how support insights influence engineering roadmap discussions. • Identify gaps in diagnostics, logging, tooling, and workflows that limit Support’s ability to resolve technical issues. • Raise the technical leverage of the Support organization. • Coach and support Support Engineering Managers in driving team performance.
About Centific Centific is a frontier AI data foundry that curates diverse, high-quality data, using our purpose-built technology platforms to empower the Magnificent Seven and our enterprise clients with safe, scalable AI deployment. Our team includes more than 150 PhDs and data scientists, along with more than 4,000 AI practitioners and engineers. We harness the power of an integrated solution ecosystem—comprising industry-leading partnerships and 1.8 million vertical domain experts in more than 230 markets—to create contextual, multilingual, pre-trained datasets; fine-tuned, industry-specific LLMs; and RAG pipelines supported by vector databases. Our zero-distance innovation™ solutions for GenAI can reduce GenAI costs by up to 80% and bring solutions to market 50% faster. Our mission is to bridge the gap between AI creators and industry leaders by bringing best practices in GenAI to unicorn innovators and enterprise customers. We aim to help these organizations unlock significant business value by deploying GenAI at scale, helping to ensure they stay at the forefront of technological advancement and maintain a competitive edge in their respective markets. About Job Operation Lead Job Summary: As an Operations Lead within Centific Solutions team, you will be responsible for the discovery phase of new opportunities in GenAI and AI data services, including scope definition, interfacing with client and internal stakeholders, pricing and design of process workflows. Additionally, the Operations Lead will support cross-functional departments to streamline operations, enhance efficiency, and drive the successful deployment of solutions that align with Centific’s strategic goals. Key Responsibilities: · Operational Strategy and Leadership: o Develop and maintain a knowledge base of pilot and program data to streamline the discovery phase of new opportunities o Develop and implement scalable operational strategies to support the delivery of solutions and services. · Process Improvement: o Identify opportunities for process improvements and drive initiatives to enhance operational efficiency and effectiveness. o Analyze current processes and workflows to identify bottlenecks and areas for optimization. · Solution Deployment: o Collaborate with Solution Engineers on new tooling evaluation, testing, and integration. o Coordinate with delivery teams and other stakeholders to ensure successful implementation. · Client and Stakeholder Management o Engage with clients and stakeholders to understand their needs and ensure that solutions meet their expectations. o Address and resolve any issues or concerns related to the deployment and operation of solutions. · Technology and Tools: o Evaluate and implement technology solutions and tools to support operational processes. o Stay up to date with industry trends and advancements to ensure that our operations remain competitive and efficient. · Cross-Functional and Global Collaboration: o Work closely with product management, engineering, delivery teams, and other teams to align operational processes with business objectives. o Facilitate communication between multicultural teams across different time-zones to ensure alignment and address any operational challenges. Qualifications: · Education: o Bachelor’s degree in data science, Operations Management, Engineering, or a related field. o Advanced degree or relevant certifications (e.g., Masters, Six Sigma, PMP) preferred. · Experience: o Minimum of 5 years of experience in service operations management, with a proven track record of leading teams and managing complex projects. o Minimum of 2 years of experience vendor-side experience, especially with Fortune 200 companies and/or large tech companies o Minimum of 2 years of experience in operations and/or project management o Experience with global and remote team collaboration o Experience with GenAI, AI, localization, or related projects o Experience preparing and presenting program data to client and internal stakeholders o Technical understanding of basic file formats, scripts and data ingestion pipelines (this role will need to manage conversations with a technical audience as part of solution design) o Advanced proficiency with the Office Tool Suite and JIRA workflows o Client-side experience, pre-sales and AI/ML experience is a plus Skills: · Strong leadership and team management abilities. · Excellent problem-solving and analytical skills. · Proficiency in process improvement methodologies and tools. · Strong communication and interpersonal skills, with the ability to collaborate effectively across departments and across time zones. · Familiarity with project management software and operational tools. · Ability to manage multiple projects and priorities in a fast-paced environment. · Strategic thinker with a focus on results. · Proactive and adaptable, with a strong sense of ownership. · Detail-oriented with a commitment to quality and excellence. Salary $100K Annually Centific is an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, ancestry, citizenship status, age, mental or physical disability, medical condition, sex (including pregnancy), gender identity or expression, sexual orientation, marital status, familial status, veteran status, or any other characteristic protected by applicable law. We consider qualified applicants regardless of criminal histories, consistent with legal requirements.
Tier 1 Support Analyst
Robbu - Business Communication SolutionsRobbu - Business Communication Solutions
• Provide customer support, delivering technical assistance and guidance. • Participate in online meetings with the team and/or clients. • Perform platform testing to validate scenarios and fixes. • Continuously develop skills and competencies outlined in the Individual Development Plan (IDP).




