Job DescriptionAs a Benefits Quality Analysis Rep II, you will be part of an extremely talented team within our Client Benefits Quality department at CVS Health. You will be responsible for analyzing client requests and performing the necessary benefits testing and quality assurance. You’ll work alongside other Benefits Coders, Testers, and Quality Assurance Representatives, as well as our Account Management and Implementation teams to deliver high quality support to our vast number of clients. Extreme attention to detail is important for this role, as your testing and quality assurance activities will impact not only the commercial clients at CVS Health, but the federal and state programs that we participate in, such as Medicare Part D and Medicaid.
This is a fantastic opportunity to start your career in the Pharmacy Benefit Management (PBM) industry, as extensive training will be provided.
Required Qualifications- 2+ years of professional work experience in Claims, Insurance, QA, Testing, or a high-production environment Preferred Qualifications - Previous work experience in a PBM, Medical Claims, Health Insurance, Pharmacy, or Benefits highly preferred.
- Provide leadership and identify opportunities to improve efficiency/quality
- Able to deliver per the timelines
- Effectively participate in RCA’s and apply the 5-Why process
- Work large / complex clients to ensure 100% test coverage and review for proper set-up that meets client intent
- Mentor and coach other team members
- Proficient use Microsoft Office applications, e.g. Excel, Word
- Project Management skills
- Responsible for maintaining your SalesForce.com (SFDC) queue at all times
- Regression Testing, Query Testing and AS400 experience preferred
Education High School Diploma or GED required.
Bachelor's 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/