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Job Title :
Adjudication Solutions Senior Advisor
Job ID :
Location :
IL - Northbrook
Street Address :
2215 Sanders Road Suite 500
Category :
Account Management
Description :
Job Description
As the Adjudication Solutions Senior Advisor, you will act in the role of lead project facilitator for the team and across departments. You will be responsible for facilitating, defining and documenting business requirements for strategic Client Services projects. The projects you own will be geared toward new development and operational efficiencies in the areas
Benefit set-up, Claims Adjudication, and the support of other operational needs. You will also be directly responsible for working with the information services department as key sign-off for all phases of the application development. Project concept, requirement sign-off, design sign-off, User Acceptance testing, implementation, training and roll-out of new functionality will also be key functions in this position. You will accomplish this by:
- Leading Multiple Key Projects with multiple contending deadlines
- Consulting with internal partners
- Facilitating internal and external meetings and presentations to provide status updates and make decisions relative to
client benefit setup and claims processing

This role is also expected to act as a team leader. As such, you will be:
- Mentoring and training junior team members
- Seeking opportunities for strategic improvements
- Managing and Driving key initiatives

Your success will be driven by your ability to effectively communicate and partner with key cross-functional partners and manage your projects across the finish-line. Your ability to juggle multiple priorities and resolve ambiguous requests will also contribute to your success. You will operate in a rapidly changing environment with tight deadlines so ability to operate autonomously and make key decisions is imperative. The contributions you will make will position CVSHealth as a leader in the PBM marketplace and position you as a leader within CVSHealth.

Required Qualifications
* 10+ years of experience leading projects and multi-functional teams in an automated production environment, with
advanced business management skills including: operations, forecasting, finance, accounting, resource/materials management, distribution, QA/QC, statistical analysis, and reporting
* 5+ years of PBM or related industry experience
* 5+ years of RxClaim System experience

Preferred Qualifications
* Progressive experience culminating in a leadership role in a health care benefits services industry or a similar industry
* Business Analyst experience Quality Assurance and/or User Acceptance Testing experience Technical Writing experience
* Demonstrated skills planning, executing, and managing complex initiatives and functions
* Ability to identify processes, functions, and procedures requiring improvement, then develop and execute appropriate
* Strong Leadership Competencies in the areas of Inspiring Trust, Open Communication, People Development, Strategic Focus
* Ability to attract highly skilled people, develop and build a high performance culture
* Working knowledge of the Microsoft suite of products
* Well-developed management, written & oral communication, and presentation skills

* Bachelor’s degree in a technical or health care related field; Equivalent 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:

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Our culture

CVS Health core values of Innovation, Collaboration, Caring, Integrity, and Accountability not only support our purpose of helping people on their path to better health for our customers and patients, but they also apply to how we support our more than 250,000 colleagues. You will find our culture at CVS Health, and our leaders encourage personal and professional growth.

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