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 The Senior Analyst, Network Relations is responsible for the accurate and timely validation and maintenance of critical provider information and inquiries. Staff are responsible for timely review, response, tracking, and routing of provider inquiries received via the Provider Engagement department email box and/or Provider Relationship Management System. Works closely with both internal and external business partners to ensure Provider inquiries are handled within a timely manner. Staff may be responsible for reviewing claims data and information. The Senior Network Relations Analyst is responsible for monthly Access and Availability monitoring as required by state regulatory requirements. Staff ensure adherence to the business and system requirements of internal customers as it pertains to other provider network management areas. - Oversees receipt of and coordinates provider inquiries from the provider network and responsible for reviewing, documenting, tracking, and routing all issues to ensure providers receive a timely response and permanent resolution. - Reviews/analyzes data by applying job knowledge and experience to ensure appropriate information has been provided. - Audits Rosters received in the provider relations department email box and works closely with the data team to ensure rosters submitted from providers are accurate. - Oversees Access & Availability monthly monitoring process. - Responsible for reviewing claims data in QNXT when provider’s inquiry involves claims payment adjudication. - Excellent written and verbal communication skills. - Conducts or participates in special projects and other duties as assigned. Required Qualifications - A minimum of 2 years' work experience in healthcare. - Must reside in Louisiana - Experience in Medical Terminology, CPT, ICD-10 codes, etc. - Experience working with the MS Office suite. Preferred Qualifications - Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claim Lifecycle, Provider Appeals & Disputes, and Network Performance Standards. - Experience in Medical Terminology, CPT, ICD-10 codes, etc. Education - Bachelor's degree preferred or a combination of professional work experience and education. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $91,800.00 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 04/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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. The Revenue Cycle Associate will be involved in the company's day-to-day revenue cycle management and accounts receivable operations to ensure timely and appropriate submission of health care claims and subsequent payment for services rendered. Core Responsibilities: - Ensure payments are collected timely and in full from payers, and perform appropriate accounts receivable follow-up for denied claims - Make use of all available tools (websites, electronic medical records, and payer systems) to efficiently identify reasons for non-payments, and follow the necessary steps for the insurance company to adjudicate the claims - Work with insurance companies to follow up on denials of claims, make necessary corrections, and refile the claim to payer for reimbursement - Process and upload checks/electronic payments for cash posting - Review/approve patient statements prior to mailing - Analyze data to identify trends and create reports for management - Interact and collaborate with administrative staff within our clinics and our billing vendor to resolve billing questions - Proficiency reading proper insurance plan and policy# from insurance ID cards - Experience using Multi-payer web portals - Ability to extract details from medical records to substantiate billing coding changes - Communicate effectively using helpdesk ticketing system to reply to clinic inquiries regarding patient statements - Contact payers to obtain clarification and/or details regarding incorrect payment/denials - Effectively work edits within claim scrubbing software - Accurately complete assignments in a timely manner - Maintain working knowledge of company policies for collections, adjustments and write offs - Possess strong critical thinking and problem solving skills to work through payers issues such as denials, underpayments and/or missing payment - Adaptable to changing procedures and a growing environment - Other duties as assigned What are we looking for? - The ideal candidate must have experience in health care accounts receivable follow-up, a good understanding of the claims revenue cycle, and EPIC experience - Must know how to read and interpret insurance Explanation of Benefits (EOB) statements - At least 2 years of working on coding denials, and understanding of NCCI edits is preferred - Solid understanding of insurance guidelines and principles including; COB, HIPAA, CPT, ICD-10, medical terminology, and managed care plans - Time management skills, and the ability to meet deadlines is imperative - education minimum of Associates degree, Bachelors preferred - excel/google sheets experienced preferred - CPB and /or CPC credentials are a plus - US work authorization - Someone who embodies being "Oaky" Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $43,888.00 - $93,574.00 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 04/13/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

At Virtua Health, we exist for one reason – to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between – we are your partner in health devoted to building a healthier community. If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment. In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 other locations, we're committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We're also affiliated with Penn Medicine for cancer and neurosciences, and the Children's Hospital of Philadelphia for pediatrics. Location: 100% Remote Currently Virtua welcomes candidates for 100% remote positions from: AZ, CT, DE, FL, GA, ID, KY, MD, MO, NC, NH, NJ, NY, PA, SC, TN, TX, VA, WI, WV only.Remote Type: On-Site Employment Type: Employee Employment Classification: Regular Time Type: Full time Work Shift: 1st Shift (United States of America) Total Weekly Hours: 40Additional Locations: Job Information: Job Summary: Responsible for enhancing, supporting, and maintaining IT applications within the Virtua Health System. Responsibilities include assistance with the optimization of the application through development of new functionality, testing and implementing scheduled vendor releases and system upgrades, and fixing system defects. Provide technical and functional application analysis, define system requirements, and develop logical data models using best practices for build and configuration, maintenance, and data integrity. Ability to understand and manage IT integrations. Ensure system changes follow change management procedures and protocols, create and maintain all documentation for all assigned applications, and develop, plan and execute testing for supported applications. Knowledge and adherence to cybersecurity and HIPAA policies and practices. Job Responsibilities: Knowledge of customer workflow, application software architecture and associated building tools to properly build and maintain application components from design specifications.   Provide day-to-day support of IT applications including error management, testing, maintenance and troubleshooting of IT systems including but not limited to application workflow, and other related activities.    Able to build new technical functionality, provide technical support and maintain IT applications within the Virtua health system with support of a Senior or Lead Application Analyst and/or Manager.    Maintains maximum system performance using appropriate tools, methods and thresholds to monitor capacity, take corrective action based upon identified opportunity and minimize system interruptions.  Responsibilities include building, testing and assisting with the implementation of scheduled vendor releases and system upgrades, fixing system defects, and error or work queue management.    Works with cross functional application teams and other Virtua clients.   Ensure system changes follow change management procedures and protocols.  Assist with project/upgrades as necessary following all project management standards.  Acts as a support resource to other IT staff. Actively participates in system build, configuration, and testing events for projects/upgrades.   Collaboratively works with vendors and IT partners to ensure on-going service and resolution of issues during upgrades and project. Able to manage multiple third-party vendor relations.  Adheres to IT Business Practices.  Adhere to IT standards with Problem Management, Change Management, Content Management, Data Courier and IT practices as required to provide on-call 24x7 support as scheduled.    Monitors ServiceNow ticketing queue to quickly troubleshoot incoming ticket incidents and requests. Works closely with other IT personnel, Virtua Clinical and Operational Business owners to ensure timely resolution of issues  Position Qualifications Required: 2-3 years of experience in IT or healthcare operations related field can also include coursework or healthcare/IT internship.  Healthcare Business or clinical specialty experience is preferred. Proficient with MS Office applications, including Word, Excel, Visio, Project, and PowerPoint.    Required Education: H.S. Diploma/GED required, Associate or Bachelor’s degree preferred or equivalent relevant experience in lieu of a degree.  Training / Certification / Licensures: IT certifications may be required as needed by Virtua. If IT certification, such as Epic certification, is required at time of hire, employee must obtain up-to-date certification in designated application(s) within 6 months of employment.  Annual Salary: $79,719 - $123,934 The actual salary/rate will vary based on applicant’s experience as well as internal equity and alignment with market data. Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including, but not limited to: medical/prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, colleague and dependent life insurance and supplemental life and AD&D insurance; tuition assistance, and an employee assistance program that includes free counseling sessions. Eligibility for benefits is governed by the applicable plan documents and policies. For more benefits information click here.

• Develop a strong understanding of internal and external data flows supporting business initiatives • Identify, access, and connect to data sources including data warehouses and third-party platforms • Evaluate existing tools, systems, and platforms used to support analytics and reporting • Analyze current business rules, logic, and system configurations to identify inefficiencies or opportunities for improvement • Map data movement across systems throughout the customer/account lifecycle • Execute data queries to validate accuracy, completeness, and integrity of datasets • Analyze performance metrics to measure success of initiatives and validate expected outcomes • Monitor portfolio health indicators including growth, profitability, and credit performance • Develop and maintain KPI reporting across key business areas such as marketing, underwriting, and account management • Build forecasting models to evaluate the financial impact of proposed solutions • Establish reporting cadence and define metric ownership across stakeholders • Create, execute, and validate recurring reports, ensuring alignment with business and system records • Perform ad hoc analysis to uncover trends, behaviors, and performance drivers • Develop presentation materials to communicate insights and recommendations to business stakeholders • Document reporting logic, data sources, and methodologies to ensure transparency and repeatability • Create and maintain a comprehensive data dictionary to standardize definitions and usage across teams