Job DescriptionAs an Enrollment Consultant, you will be responsible for resolving enrollment discrepancies and performing complex and escalated enrollment tasks. You will have the opportunity to develop and maintain strong relationships in this heavy client facing role with our State Pharmaceutical Assistance Programs (SPAP) clients and our Employer Groups Waiver Plan (EGWP) clients. Direct impact to clients by building and maintaining strong relationships through proactive issue resolution. You will be essential to ensure all eligible beneficiaries are properly enrolled in their respective Medicare D plans and perform in accordance with Center for Medicare & Medicaid Services (CMS) guidelines. You will serve as the business expert supporting assigned and non-assigned clients which leads to retention of client base through successful results.
You will accomplish this by: -Researching, processing, and finding solutions for routine and complex enrollment issues -Lead and perform activities related to servicing our clients with immediate resolution of client inquiries -Monitor enrollment processes across multiple enrollment systems/processes -Lead re-implementation efforts with clients. i.e. CAG additions, member moves, vendor changes -Making sound business decisions based on instructions, policy and procedures with minimal supervision -Communicating professionally with internal partners and co-workers, promoting a healthy work environment -Positive adaptability in a changing environment -Facilitate and document client meetings (Conference Calls and/or Onsite meetings) -Create and/or update client documentation -Attend off site client meetings (about 10% travel)Required Qualifications2+ year of Healthcare, PBM, or Insurance related experience 2 + years of Secure File Transfer Portal (SFTP), Electronic Data Interchange (EDI) formats and file transfer protocols 2+ years of progressive Business to Business client relations, preferably in Account Management 2+ years of current experience with Microsoft Excel, Outlook, PowerPointPreferred QualificationsEffective presentation skills over the phone and in person Proven ability to interpret and present complex concepts that are easily understood by others Demonstrated strong written and verbal communication skills Strategic, forward thinkers, solution focus with sound technical and analytical abilities Courteous and professional demeanor with the desire to work individually as well as within a team Prior experience with RX Claim (AS400), SalesForce 1 + years of current experience with MS PowerPoint, Visio and AccessEducation
Verifiable High School Diploma or GED Required
Bachelor Degree strongly preferredBusiness 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: https://jobs.cvshealth.com/