As a Business Audit Support Consultant, you will support Medicare Part D Enrollment Operations through the creation, review and analysis of process audits, providing support to the business with any/all CMS audit tasks and monitoring of the Corrective Action Plans (CAP) of impacted daily process tasks. You will interact with internal partners across various levels in the organization to assist in developing solutions, solving problems or implementing process controls that ensure member accuracy in processing. You are expected to complete required training courses, process technical training, and utilize resources available in order to exceed expectations.
As a Consultant you will:
- Review/audit the following: Internal Audit results, CMS Audit requests, SSIC/NEJE Audit requests, and client-requested audits
- Contribute to the team with the creation of the monthly Enrollment Data Validation (EDV) packets for CMS
- Take the Lead on special projects, as needed
- Have the flexibility to be able to work different tasks/processes outside of the Audit Support team, helping other teams with their tasks, as neededRequired Qualifications
- 2+ years’ in Healthcare, Prescription Benefit Management (PBM), or Medicare Part D or comparable federally regulated business.
- 2+ Years MS Office Applications including, MS Excel, MS Access and SharePoint Preferred Qualifications
-Intermediate to advanced understanding of CMS guidelines for Med D enrollment processes or previous work experience in a regulatory environment.
-Previous experience processing pre and post Med D enrollment functions using FACETS, FAZAL, PEGA and RxClaim
-Advanced organizational skills, critical thinking skills, and ability to multi-task
-Time management skills
-Capable of working well in a team setting as well as an individual contributor.
-Must be highly motivated, creative and innovative
-Ability to effectively communicate issues, findings, and recommendations both verbally and in writing to all levels of management
-Excellent analytical and problem solving skills
-Previous auditing experienceEducationVerifiable GED or High School Diploma is required Bachelor’s Degree 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
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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/