Provider Digital Issue Research & Resolution Project Manager

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

This role is for a position on the Issue Research and Resolution team within Provider Digital Operations organization. It involves support of our Digital Portal and provider electronic data interchange transactions. Main responsibilities include receiving issues directly from our Digital Portal users and internal customers, problem solving/troubleshooting, identification of appropriate systems based on the issue at hand, prioritization of issues and communicating complex technical details in a business-friendly manner understandable to our customers.

• Maintain colleague access to the Digital Portal
  • Review colleague requests for portal access
  • Utilize reports to remove colleagues who no longer require access or have left the company.
• Handle incoming support tickets related to Digital Portal functionality
  • Use knowledge of the Portal and Systems to determine whether the ticket is Portal-specific or not. 
  • Respond to resolved tickets in a thoughtful, easily understandable way.
  • Send to EDI Consultants if issue requires more detailed Aetna system analysis or is not Portal-specific
  • Identify new/trending issues and share with manager for reporting purposes
• Represent the Digital Portal during Aetna Immediate Response Team (IRT) issue calls
  • Act as liaison between the IRT and the Digital Portal team
• Monitor Availity downtime/performance issues and share updates as they are available
• Assist with communications related to the Digital Portal as needed
•  Represent the Digital Portal on the Intake & Digital Operations Work Intake Committee
  • Use knowledge of the Digital Portal during work request reviews to respond correctly for Digital Operations’ involvement with the project/SR/Work request.
• Support the Digital Portal Change Request (CR) process
  • Act as the liaison between the requester and the Digital Portal team
  • Share CR form with the requester
  • Meet with them to ensure form is sufficiently completed
    • Submit the form to the Digital Portal team
  • Schedule and facilitate bi-weekly CR Review meetings
    • Act as the single point of contact for Change Requests
    • Ensure that updates are shared with requesters
    • Obtain answers to questions on behalf of requesters and communicate the response back

Required Qualifications

• Working knowledge of the provider Digital Portal
• 2-4 years related work experience in the Provider Contact Center.
• 2-4 years of EPDB experience
• 1-3 years of EWM experience
• 1-3 years of Salesforce/ GPS experience
• Advanced skills in Outlook

Preferred Qualifications

• 1-3 years of Service now experience
• 3-5 years of experience in usage of EWM
• 1-3 years of ACAS experience
• 1-3 years of ICD-10, HCPCS, CPT experience
• Exposure to AEPPAYS
• Proficient use in Excel ​

Education

• Bachelor's degree or equivalent experience of 2-4 years.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,300.00 - $159,120.00

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 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/benefits

We anticipate the application window for this opening will close on: 10/31/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.