Job DescriptionAs a Senior Consultant on the Client Services Quality team, you will be responsible for designing, developing and delivering all aspects of Benefits and IT Quality projects as part of new client implementations. The role requires cross functional collaboration with IT and business partners from business requirement gathering, understanding benefits design, mapping for accurate claims adjudication, building test plans, testing cases and executing them to test all functionalities. You will work closely with senior team member's and support them in key activities of testing lifecycle. The goal is to improve efficiency and accuracy for new client implementation and identify opportunities to improve overall quality.The exciting things you will be involved in include, but are not limited to the following: -Collaborating with key internal and external stakeholders to gather and analyze needs and requirements to design and implement quality solutions to support successful go live -Actively working with client's core team members to present and review test approach, test cases and test results from different testing phases -Collaborating with other analytic resources to envision and prototype business intelligence tools based on the predictive modeling functionality -Constructing and delivering written status reports in a variety of formats (reports, PPT, including visualization of data and findings), and effectively presenting the results to potential non-analytic audiences -Hands on test planning and test execution activities -Managing complex projects related to a wide variety of operational business needs.Required QualificationsTo be considered for this exciting opportunity, candidates will need to have a minimum of 3 years of professional experience in healthcare industry; -3+ years of experience working on medium to complex projects with audit, quality roles; -2+ years of experience working with pharmacy claims -2+ years of experience with claims adjudication systemPreferred QualificationsPBM experience is preferredAS400 experience is preferredEducation
Bachelor's DegreeBusiness 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/