Job DescriptionWe are looking for passionate, driven people who want to join a high energy and growing team that will make a difference in our customers’ lives and who is willing to work on the ground floor of Client Implementations and Process Improvements.
This is a Consultant position within the Testing Center of Excellence (TCoE) department. This individual will support Clinical Testing and work with our internal customers along with other job duties as required. This Consultant will need to identify the best approaches and strategies for ensuring the accuracy of Clinical Testing and could be requested to discuss test results with senior leadership across multiple lines of business.
This Consultant will work as team Member for Clinical Testing team, which will include running queries, Claims and analyzing testing defects either within the TCoE department or with our Internal Customers. This individual will be required to identify areas of improvement and will need to successfully engage internal business partners and leaders as needed; to resolve issues, drive results and meet project target dates as required by management.
This Consultant will participate in process improvements across multiple business units as required by Client Services leaders. This individual will work with Client Benefits, Account Management and Implementation management along with senior leadership to improve the overall Quality of the Client Implementation experience.
Required Qualifications- 4+ years of Healthcare experience
• Demonstrate ability to analyze data, verify accuracy and determine conclusions
• Ability to run the RzTest Tool and analyze the data spreadsheets
• Strong analytical skills and attention to detail. Ability to define problem, collect data, establish facts, draw valid conclusions and perform the necessary Root Cause Analysis.
• Knowledge and experience with Client Operations in a PBM environment.
• Prioritize, manage multiple assignments, and direct the work of others to meet deadlines.
• Working knowledge of Microsoft Office applications including Word, Excel, Power Point and Access.
- Experience with Visio, Project also a plus. Preferred Qualifications- 2+ years of PBM experience preferred.
- Excellent communication (Verbal and Written) and collaboration skills.
- Superior organization, project management, and prioritization skills.
- Courteous and professional demeanor with the desire and ability to work as a team.
- Strategic, forward thinkers with sound technical and analytical abilities.
- Ability to interact and influence with senior leadership of the organization.
- Firm understanding of Federal and State agencies and their role in Healthcare legislation.
- Firm understanding of Healthcare documentation and resource requirements.
- Deep knowledge in Health Plan benefits structures.
- Experience with SQL and Queries is preferred.
- Thorough and detailed knowledge of investigating, analyzing and effecting corrective action using experience to apply various methods and techniques that promote timely change and accountability.
- Strong analytical skills and attention to detail.
- Ability to define problem, collect data, establish facts, and draw valid conclusions.
- Knowledge and experience with Clinical Operations in the Medicare Part D environment.
- Ability to research, analyze and interpret CMS rules and regulations, then apply them to current work assignments.
- Working knowledge of Microsoft Office applications including Word, Excel, Power Point and Access
- Knowledge of RxClaim (AS400), EZQuery and EZTest tools
EducationBachelor’s degree required; equivalent work experience may substitute.Business Overview
Coram CVS/specialty infusion services is a leading national provider of specialty home infusion and specialty pharmacy services. The integration of Coram into CVS Health enables the company to offer enhanced, comprehensive infusion services; expanded payer access; and a national network of more than 85 locations, including 65 ambulatory infusion suites. Providing infusion therapies and services to over 20,000 patients each month, Coram cares for patients through all phases of their healthcare continuum including clinical and compliance monitoring, and individual patient counseling. CVS Health, through our unmatched breadth of service offerings, is the nation’s largest pharmacy health care provider transforming the delivery of health care services in the U.S. Our energetic and service-oriented colleagues embrace fresh ideas, new perspectives, a diversity of experiences, and a dedication to service to meet the needs of the many people and businesses relying on us each day.
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/