Position Summary
This is a Scrum Team role that will be a member of the Medicare / Medicaid / Exchange Enrollment Configuration team tasked with developing purpose-built capabilities for our NextGen platform. This role is responsible for delivering analysis and requirements of oversight for various Membership Integration and Reconciliation Stories within an Agile framework.

• Assist in defining the product vision -Establishing a clear vision for the product that aligns with the company’s goals and customer needs.
• Assist in managing the product backlog -prioritize and maintain the product backlog, ensuring it reflects the most valuable features and improvements.
• Stakeholder management -Collaborating with stakeholders to gather requirements, provide updates, and ensure their needs are met.
• Setting Acceptance Criteria -Defining clear acceptance criteria for each feature to ensure the development team understands the requirements and can deliver quality work.
• Coordinating with the development teams -Working closely with development teams to plan sprints, answer questions, and ensure the product is built according to the vision and requirements.
• Performs analysis and translate business needs to create high-quality Business Requirements and Functional Specifications documentation within specified time frames to solve moderately complex problems (multiple interfaces with other systems within a business unit) considering all impacted components from an end-to-end perspective.
• Performs data analytics using SQL / PLSQL at an intermediate level
• Ensures end-to-end traceability of requirements is complete.
• Applies specific functional and/or business expertise to perform assigned tasks and develop specific project deliverables.
• Conducts impact analysis of configuration changes on business processes and existing technology.
• Competent to work with minimal supervision in a technical capacity on most phases of the business systems analysis.
• Contributes to the review of Test Planning and Test Execution strategies.
• Develop business workflow diagrams.
• Assists in the development of data models and interface design specifications.
• Documents, tracks, and resolve issues related to data quality.
• Contributes to the design and mapping of data conversion strategies.
• Participates in collaborative system and data design sessions with the user community, technical architecture resources, and development resources.
• Completes project activities on time and within budget and proactively identifies and communicates issues that may jeopardize milestones or project budget to the Project Manager / Product Owner.
• Adheres to SDLC or AGILE project management methodology by utilizing internal procedures and tools and identifying areas for methodology improvement.
• Develop Product Overviews, FAQs, Tool Glossaries, system training material, and system user documentation to support implementation activities.
• Creates appropriate communication materials are documented and distributed appropriately.
• Conducts interviews, fact-finding, and independent research to design creative, progressive solutions for business problems.

Required Qualifications

• Experience as a Business Analyst (or equivalent) supporting Medicare and Medicaid programs in an operational and/or technology context (2-4 years)
• Experience as a product owner or similar role/position as a business analyst/project manager (2-3 years) Experience with querying PLSQL / Oracle databases, SQL Server; Intermediate to Advanced (2-4 years)
• Experience with software development lifecycles, having owned: detailed analysis (data / process analytics, process improvements, process flow creation, requirements gathering, requirements traceability through the software delivery lifecycle, including post-production checkout / reviews. (4-6 years)
• Experience with extensive analytical techniques (Scenarios and Use-cases, Scope Modeling, Functional Decomposition, Interviews, Observation / Job Shadowing, Focus Groups, Acceptance and Evaluation, Sequence Diagrams, User Stories, Brainstorming, Storyboarding, Prototyping, Event Analysis, Business Rule Analysis, Requirements Workshops, Risk Analysis, Root Cause Analysis) (4-6 years)

Preferred Qualifications

• Experience with Market Prominence, MHK's (formerly MedHOK) Enrollment, Billing and Correspondence platform
• Information Technology / Release & Resource Management (2-4 years)
• Medical Management / Medical Management - Government Administration (2-4 years)
• Experience with member materials / correspondence implementation experience (2-4 years)
• Experience with Medicare or Medicaid Enrollment, Billing and Correspondence Operations (2-4 years)
• Leadership / Creating Accountability (Intermediate)
• Leadership / Developing and Executing Strategy (Intermediate)
• Leadership / Driving a Culture of Compliance (Foundational)
• General Business Consulting for Solutions (Intermediate)
• Leadership / Anticipating and Innovating (Intermediate)
• Technology / Justifying the Business Case (Intermediate)
• Experience with enterprise-wide and / or cross-functional large-scale initiatives with high degree of complexity.
• Demonstrated experience successfully implementing change in complex organizations
• Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.

Education

• Bachelor’s Degree or equivalent experience

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

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. 

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.

Additional details about available benefits are provided during the application process and on .