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Job Title :
Client Benefits Testing - Senior Consultant
Job ID :
753314BR
Location :
TX - Irving
Street Address :
750 W John Carpenter Fwy Ste 1200
Category :
Analytics|Medicare
Description :
Job Description
We are looking for passionate, driven people who want to join a high energy and growing team that will make a difference in our customers’ lives and who is willing to work on the ground floor of Client Implementations and Process Improvements.

This is a Sr. Consultant position within the Testing Center of Excellence (TCoE) department. This individual will support Formulary, UM testing and Benefits testing and work with our internal customers along with other job duties as required. This Sr. Consultant will need to identify the best approaches and strategies for ensuring the accuracy of Formulary, UM and Plans and could be requested to discuss test results with senior leadership across multiple lines of business.

This Sr. Consultant will serve as a subject matter expert (SME) for Formulary and UM issues, which will include running queries and analyzing Testing defects either within the TCoE department or with our Internal Customers. This individual will be required to identify areas of improvement and will need to successfully engage internal business partners and leaders as needed; to resolve issues, drive results and meet project target dates as required by management.

This Sr. Consultant will participate in process improvements across multiple business units as required by Client Services leaders. This individual will work with Client Benefits, Membership Operations, Account Management and Implementation management along with senior leadership to improve the overall Quality of the Client Implementation experience.


Required Qualifications

- 4+ years of experience in Healthcare or PBM
- Demonstrate ability to analyze data, verify accuracy and determine conclusions
- Ability to run the EzTest Tool and analyze the data spreadsheets
-Strong analytical skills and attention to detail. Ability to define problem, collect data, establish facts, draw valid conclusions and perform the necessary Root Cause Analysis .
- Knowledge and experience with Client Operations in a PBM environment.
- Prioritize, manage multiple assignments, and direct the work of others to meet deadlines.
-Working knowledge of Microsoft Office applications including Word, Excel, Power Point and Access.
- Experience with Visio, Project and other testing tools also a plus. RxClaim knowledge



Preferred Qualifications
· Excellent communication (Verbal and Written) and collaboration skills.
· Superior organization, project management, and prioritization skills.
· Courteous and professional demeanor with the desire and ability to work as a team.
· Strategic, forward thinkers with sound technical and analytical abilities.
· Ability to interact and influence with senior leadership of the organization.
· Firm understanding of Federal and State agencies and their role in Healthcare legislation.
· Firm understanding of Healthcare documentation and resource requirements.
· Deep knowledge in Health Plan benefit structures.
· Experience with SQL and Queries is preferred.
· 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.
· Strong analytical skills and attention to detail. Ability to define problem, collect data, establish facts, and draw valid conclusions.
· Knowledge and experience with Clinical Operations in the Medicare Part D environment.
Ability to research, analyze and interpret CMS rules and regulations, then apply them to current work assignments.
· Working knowledge of Microsoft Office applications including Word, Excel, Power Point and Access
· Knowledge of RxClaim (AS400), EZQuery and EZTest tools


Education
Bachelor’s degree required; equivalent work experience may substitute.

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: https://jobs.cvshealth.com/

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