Payer Integrity Analyst, Revenue Cycle (Remote)

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary

The Payer Integrity Analyst plays a key role in supporting the implementation, maintenance, and optimization of payer contracts. Working closely with the Lead Contracting Director and cross-functional teams, this role ensures the seamless integration of payer requirements into internal systems and workflows. The Analyst will collaborate with departments such as Revenue Operations, AR, IT, and Clinical Operations to drive contract accuracy, operational efficiency, and payer compliance.Key Responsibilities

Contract Implementation & Maintenance

• Research, document, and maintain payer-specific requirements for system implementation.
• Manage and update payer fee schedules for assigned contracts.
• Support the implementation of new services in collaboration with MinuteClinic operations.

Stakeholder Collaboration

• Serve as the primary point of contact for assigned payers.
• Partner with internal teams including Contract Administration, Revenue Cycle Operations, and IT to ensure contract alignment and execution.
• Build and maintain strong relationships with internal and external stakeholders.

Process Optimization & Training

• Identify and implement process improvements, automation opportunities, and workflow enhancements.
• Assist in onboarding and training new team members.
• Contribute to the development of standardized policies, procedures, and training materials.

Cross-Functional Integration

• Collaborate with departments such as Credentialing, Billing, Compliance, Legal, Marketing, and Call Center teams to ensure effective contract integration.
• Support data analysis and reporting to inform business decisions and contract strategies.

Remote Work Expectations

• This is a 100% remote role; candidates must have a dedicated workspace free of interruptions.
• Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.

Required Qualifications

• 5+ years of experience in the health insurance industry.
• Strong knowledge of insurance payers and contract structures (national, regional, or local payers).
• Proficiency in Microsoft Excel (Pivot tables, VLOOKUP) and Microsoft Teams.
• Excellent communication and collaboration skills.

Preferred Qualifications

• Experience with Epic, AthenaHealth, or similar healthcare systems.
• Background in health plan contract implementation experience.
• Familiarity with contract management systems or similar databases.
• Strong analytical skills with the ability to interpret data and make informed recommendations.
• Experience developing and delivering presentations to stakeholders.

Education

• High School Diploma or GED required.

Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$43,888.00 - $85,068.00This 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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 09/03/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): East Lansing, MI

Job ID: CVS-R0654813

Employment Type: OTHER

Posted: 2025-08-15T19:58:29