As a Med D Finance Consultant, you will support all Adjustment Triage related requests and communications, weekly Adjustment Triage and Service Warranty calls, adjustment claims review training, Adjustment Triage Work Instruction updates, and document Adjustment Triage activities as needed. You will also coordinate development of new documentation, new training materials, and work cross functionally to ensure retrospective claims adjustment activity is appropriately completed with timely resolution and visibility. You will provide support to the Med D Finance Reconciliation management leaders as needed. Additionally, you will support cross functional activities (PDE, COB, Automation) within the Med D financial reconciliation department with tasks when requested.
As a Med D Finance Consultant, you will work directly with internal business partners to understand retrospective claim review and reprocessing related issues, resolve questions/issues/concerns, resolve conflict/misunderstandings, facilitate calls with business partners, and review and analyze financial data. Other support duties will include, but are not limited to: validation report review, quality review, departmental reporting, and other duties as assigned by the supervisor or manager. You will also interact cross functionally with other internal and external business partners and therefore, proficiency in managing and leading projects as a subject matter expert is necessary. Success in this role will require excellent communication skills, a willingness to partner cross functionally with internal and external business partners.
This opportunity is within the CVS Heath Med D business and therefore will require a constant focus on maintaining compliance with Federal and State regulations.
Required Qualifications- 2+ years of professional work experience required, Healthcare or PBM specific experience strongly preferred
- 2+ years of experience using MS Word, MS Access, and/or MS ExcelPreferred Qualifications- Excellent communication skills
- Excellent technical and analytical skills
- Ability to problem solve in concert with all levels of the organization and with clients
- Critical thinking skills and ability to solve moderate to complex issues
- Ability to work independently and in a team environment
- Ability to function in a high volume, fast paced environment Education- Bachelor's degree preferred. Verifiable High School diploma or GED Required.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
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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/