Bring your heart to CVS Health. Every 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.

　　Position Summary

　　We are currently seeking an experienced Medicaid and Medicare Coding specialist to serve as internal consultant on current coding/reimbursement requirements of Medicaid and Medicare. This role involves providing expert advice and oversight of accurate coding of health services covered under highly-integrated Dual Eligible Special Needs Plans (Medicare and Medicaid).

　　The ideal candidate will have experience guiding system configuration teams in determining coverages under health plans that offer both Medicaid and Medicare; provides guidance for ICD-10, CPT, and HCPCS codes that includes in-depth analysis, review, and validation of Medicare/Medicaid coverage , knowledge of Medicaid fee schedules and coding manuals, abreast of and interprets changes in coding guidelines and regulations pertaining to Medicaid and Medicare and collaborates with internal stakeholders to ensure accurate and compliant benefit administration.

　　Required Qualifications

　　Expert knowledge of Medicare and Medicaid coding/reimbursement rules

　　Healthcare or Managed Care industry experience

　　Extensive experience in medical coding with a deep understanding of Medicare and Medicaid guidelines

　　Excellent analytical, advisory and communication skills

　　Proven ability to work collaboratively and provide effective guidance and leadership

　　5+ years' experience in business operations or consulting, working with medical billing and/or claim coding

　　Ability to work with all levels of management.

　　Ability to manage various duals projects as assigned

　　Ability to identify and resolves issues that impact platform readiness

　　Preferred Qualifications

　　Certification in medical coding with specialized knowledge in Medicaid and Medicare coding

　　Project Management experience

　　Group facilitation experience

　　Education

　　Bachelor's degree in a Business or Healthcare field, or an equivalent combination of education and work experience in a related field

　　Pay Range

　　The typical pay range for this role is:

　　$60,300.00 - $130,000.00

　　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.

　　In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

　　For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

　　CVS 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.

　　CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.