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Job Title :
Clinical Configuration Coder II
Job ID :
Location :
TX - Irving
Street Address :
750 W John Carpenter Fwy Ste 1200
Category :
Information Systems
Description :
Job Description
This position performs key centralized Clinical Coding Analyst activities and works closely with Coding Advisers, Clinical Requirement Advisers, Clinical Coding Managers, and others as needed to assure operational excellence with meeting quality standards.

This position will be expected to maintain the client clinical configuration for Formulary and Utilization Management up within the Health Plan Clinical Benefits department. They are expected to demonstrate a high level of client service through the execution of accuracy, responsiveness, reliability, and professionalism on every interaction. This position will support these efforts for the following lines of business such as Commercial, Medicare D, Medicaid and Exchange. The primary focus will be supporting the configuration of Formulary rules and Utilization Management programs which include simple and complex rules.

Required Qualifications
2+ years of direct work experience including experience with RxClaims or AS400
1+ year of experience working in an analytical environment

Preferred Qualifications
- Proficient in the following programs: Microsoft Excel, Microsoft Outlook, Microsoft Access, PBM Knowledge
- Able to apply logical thinking and analytical skills to: research claims issues, formulate a strategic approach to efficiently build plans by performing analysis, and then execute and validate the plan build
- Able to thrive and be successful in a fast-paced, operational environment that is very client centric; where there is high variability between clients’ plan designs
- Capable to apply logical thinking and analytical skills to: research claims issues, formulate a strategic approach to efficiently build plans by performing analysis, and then execute and validate the plan build
- Exhibit the ability to make decisions independently by applying sound judgment based on business principals and supporting data facts
- Salesforce

High School Diploma/GED required
Bachelor Degree preferred
CPhT certified preferred

Business Overview
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.

CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking EEO AA CVS Health

CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.

For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website:

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CVS Health core values of Innovation, Collaboration, Caring, Integrity, and Accountability not only support our purpose of helping people on their path to better health for our customers and patients, but they also apply to how we support our more than 250,000 colleagues. You will find our culture at CVS Health, and our leaders encourage personal and professional growth.

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