Position Summary: The Clinical Services Advisor will provide technical, analytical andbusiness support for all assigned programs for Med D, Medicaid, and commercialproducts. Programs include End-Stage Renal Disease (ESRD), Hospice, Transplant,Transition Fill, Vaccine Administration and Provisional Supply. Success in thisrole will be based on your ability to provide guidance to internal and externalbusiness partners, accountability and collaboration for resolving issues.You'll also ensure compliance with all client & regulatory requirements.
This role will serve as the subject matter expert (SME) for program processes to internal and external business partners. You will be assigned to produce business process documentation, such as policies and procedures, job aides and work instructions and will analyze daily program reporting and RxClaim adjudication data. You’ll also support internal and external audits as requested and ensure that audit responses are timely and accurate.
Required Qualifications: * 5+ years of Pharmacy Benefit Management or Medicare Part D program experience
* 5+ years demonstrated experience with Microsoft Office Suite
Preferred Qualifications: * PBM claim adjudication experience is preferred
* Data analysis and SAS experience is preferred
* Pharmacy Technician Certification (CPhT) strongly preferred
Education: Bachelor's degree is required; equivalent work experience may substitute.
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
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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/