CVS Health has a dynamic opportunity for a Pharmacy Revenue Cycle Director to join our dedicated team. As the Director of Pharmacy Revenue Cycle you will be responsible for all operations in the CVS Health Retail Pharmacy Accounts Receivable area with annual insurance revenue of more than $50B across more than 900 pharmacy and medical payers including Commercial, Medicare Part D, Medicare Part B, and Medicaid programs.
As the Director will lead a diverse 70-75 person team across several operational areas including back-end billing, collections, cash application, denial resolution, payment exception reconciliation, and third party audits. The ideal candidate would benefit from an understanding of the pharmacy or healthcare industry including standards related to claim adjudication and electronic remittance as well as state and federal prompt pay requirements.
This role is ultimately responsible for all aspects of Retail Pharmacy Third Party Accounts Receivable and for building a sustainable environment that minimizes risk and delivers the best possible short and long term results.
Key responsibilities include:
- Building a high performing team through effective hiring and development of staff and driving increasingly high levels of engagement throughout the team. -Devising and executing short and long term strategies that ensure effective and efficient operations while anticipating new business opportunities and challenges. - Setting the direction for the organization and relevant tools, vendors, and systems in a manner that drives productivity, quality, and results. - Creating an environment of continuous improvement that allows for the assumption of growth within the current framework. - Partnering effectively across boundaries within the organization to promote collaboration, identification of synergies, risk mitigation, and the delivery of comprehensive enterprise solutions. - Developing strong relationships with payers to promote timely identification and resolution of business issues and opportunities. - Drive budgeting and forecasting activities, regularly interacting with senior leadership to account for results, expectations, and contributing business dynamics.
Required Qualifications- Minimum of 3 years of leadership experience
Preferred Qualifications- 5+ years of experience leading a large team, ensuring continual development, effective coaching, and driving high levels of engagement.- Demonstrated history of identifying, hiring, developing and retaining talented team members. - Experience instilling a process improvement culture and driving key initiatives. - Highly developed relationship-building and influencing skills to foster effective partnerships across the enterprise as well as with external business partners. - Ability to communicate effectively to a diverse audience – verbally, electronically, and otherwise - throughout all levels of the organization - Strong analytical, critical thinking, organizational and time management skills. - Ability to drive long term strategy while remaining focused on short term results. - Excellent prioritization and planning skills; must be able to translate strategy to action. - Ability to work in strict confidence, ensuring the confidentiality of patient, medical, and financial records at all times in compliance with company and HIPAA Privacy guidelines.Education Bachelor’s Degree or equivalent years of related professional work experience in combination with education may be considered in lieu of a degree.
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/