CVS Health is looking to solve the business and technical problem of ensuring 100% adherence to CMS and state Interoperability compliance regulations for Provider Access and Prior Authorization APIs, translating these regulations into efficient, highly functional code using the Fast Healthcare Interoperability Resources (FHIR) format.
Requirements
- 10+ years work experience
- Adept at problem solving and decision making skills
- Adept at collaboration and teamwork
- Adept at growth mindset (agility and developing yourself and others) skills
- Adept at execution and delivery (planning, delivering, and supporting) skills
- Adept at business intelligence
- Certified Systems Engineering Professional (CSEP) preferred.
Responsibilities
- Responsible for the technical strategy, direction and leadership of the Provider Access and Prior Authorization APIs.
- Translate CMS and state Interoperability compliance regulations into efficient, highly functional code using the Fast Healthcare Interoperability Resources (FHIR) format.
- Ensure the technical direction of the design adheres to the architecture solution and roadmap.
- Translate business needs to create high-quality requirements.
- Ensure successfully delivery of key Prior Authorization and Provider Access functionality as mandated by the significant CMS 0057-f mandate, the additional new state compliance mandates, as well as the emerging non-compliance initiatives that bring significant value to Aetna, our members, providers and the entire healthcare industry.
- Responsible for planning with the architecture runway and technology strategy in mind.
- Leads team in technical feasibility exploration and in alignment with architectural guardrails and engineering best practices as part of solution analysis/ discovery.
Other
- Fostering a strong collaborative environment within your team and also with Interoperability business leadership, architecture, partner teams, and other organizations, will be critical to success.
- Perform occasional mentoring of new Software Engineers.
- Ensure that all compliance requirements are delivered successfully, before the mandated deadlines.
- Issues are triaged and addressed, and all pertinent issues are brought to Digital Data Analytics Technology (DDAT) leadership in an organized, succinct manner.
- Collaborate with Interoperability business product owners and managers to understand their priorities, problems, and goals.
