Analyst, Dental Healthcare

at  CVS Health

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.

REQUIRED QUALIFICATIONS

Comprehends contemporary dental care standards, practices, and procedures.
Possesses high level of technical knowledge and radiograph interpretation skills.
If certified or licensed, maintains required continuing education requirements.

PREFERRED QUALIFICATIONS

Uses available resources efficiently.
Is well organized, continually focusing upon maximal utilization of time and talent.
Embraces change and readily accepts additional responsibilities.
Researches issues thoroughly and reports findings clearly, providing options for resolution.

EDUCATION

Vocational school or college level training beyond high school
CDA. RDA, RDH with at least five years clinical experience

This position supports the daily processing of appeals in the Par Provider Dental Appeals.
Job functions include, completing appeals determination letters, prepping dental requests, updating systems, completing reporting as necessary, working collaboratively with clinical support staff (Medical Directors, Nurses, Providers, etc.), and movement of cases in the MedHok system.
All work is to be handled in compliance of turnaround times and regulatory standards.
Responsible for managing to resolution complaint/appeal scenarios for dental products, which may contain multiple issues and may require coordination of responses from multiple business units. Ensure timely, provider focused response to complaints/appeals.
Identify trends and emerging issues and report and recommend solutions.