Job DescriptionAs the Benefits Testing Advisor, you will take full ownership and serve as subject matter expert for all Clinical and Benefits Plan Testing to include, but, not limited to benefit plan coding, client Implementations, benefit plan
testing, and test result presentation to key internal and external stakeholders.
In this role you will work through the various phases of the project until all issues have been resolved, cleanup complete and all reportable items are closed to the satisfaction of senior leadership. You will need to facilitate cross functional work groups and collaborate with Integrated Accumulations, Benefits and Implementation colleagues to ensure all parties understand and implement what is needed for accurate up and down stream processing. You will actively participate on client calls and act as a liaison between the Information Systems and Implementations teams for issue resolution.
You will be responsible for:
- Defining Benefit Plan, Clinical test requirements
- Creating test plans, and executing test scenarios to capture test results and present test results to all stakeholders.
- Performing system validation and user acceptance testing to minimize financial exposure and customer disruption
As the Benefits Testing Advisor you will create heat tickets and develop BSRs to alert internal partners of critical needs and ensure processes meet internal and client audits. You will also be involved in developing process improvement initiatives in support of department efficiencies and pinpoint areas of opportunity and training needs. You will also consult and mentor colleagues in performing clinical benefit plan set ups and testing in support of client requirements.
Required QualificationsMinimum of 7 years of overall experience in testing of benefit plan set up for a health plan or related testing experience
3 or more years of experience in one or more of these areas: PBM plans, Medicare, Medicaid, Commercial, HMO
Willingness and ability to travel up to 30% as needed for project collaboration and stakeholder meetings
Preferred QualificationsExcellent communication (Verbal and Written) and collaboration skills
* Superior organization, project management, and prioritization skills
* Strategic, forward thinkers with sound technical and analytical abilities
* Ability to interact and influence with senior leadership of the organization
* Deep knowledge in Health Plan benefit structures
* Experience with SQL and Queries
* Thorough and detailed knowledge of investigating, analyzing and effecting corrective action using experience
to apply various methods and techniques that promote timely change and accountability
* Project Management expertise and well organized with the ability to effectively prioritize
* Strong analytical skills and attention to detail
* Knowledge and experience with Clinical Operations in the Medicare Part D environment as well as CMS guidelines
EducationA Bachelors Degree is required
* Masters Degree is preferred
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/