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Sr MgrClient Ben Test

Company: CVS Pharmacy
Location: Irving
Posted on: May 26, 2023

Job Description:

Job DescriptionAs the Client Benefits Senior Manager, you will play a key role within CVS Health Benefits Operations, leading a team of Testing & Quality Assurance colleagues. Your span of control covers multiple sites while partnering closely with other benefit operations teams and external service providers. This is a client- facing role. In this role you will be working with a cross functional team in benefits, clinical, account management, and network to ensure the success of health plan benefits quality As the Senior Manager you will also assist in the management and follow-up of benefit operations, compliance audits, development and follow-up of corrective action plans (CAPs) and quality improvement plans and provide timely executive support for material development (e.g., presentations, critical metrics). You will have oversight of the implementation of the drug benefits, development and implementation of rigorous processes and solutions to ensure very high-quality testing and release management work. This includes management and oversight of quality reviews and compliance to required quality standards.As a Senior Manager of Client Benefits Testing with CVS Health you will lead approximately 10-15 colleagues and 20-30 contractors in testing health benefits for clients. You will be responsible for managing resources and the testing of benefits and clinical changes for our Pharmacy Benefits Management (PBM) clients.Major areas of responsibility include leading and assisting with testing strategies, design efficient testing methods for complex implementations, oversight of the implementation of the drug benefits, development and implementation of rigorous processes and solutions to ensure very high quality testing deliverables and programs that improve the knowledge levels of the benefits testing staff. Additional responsibilities will include participation in internal meetings to review test evidence with key stake holders and provide detail/summary reports of testing to the clients. Your role will entail dedicated planning, effective communication, coordination and project management of select organizational initiatives, leadership team agenda development, action tracking and follow-up, and coordinating quality automation projects.Success in this role will be determined by your ability to meet or exceed customer service levels as well as evaluating issues coming from production corrections and handling client concerns. You will need to use your knowledge of core PBM/managed care functions with a focus on quality of benefit operations, clinical and the Rx Claim Adjudication system as well as your understanding of healthcare industry business processes including fundamental concepts regarding Regulatory requirements. You will also need to bring your deep understanding and experience with healthcare prior authorization, Formulary, Utilization Management, Drug Utilization Management, Accumulations & Copay setup, reimbursement and claims adjudication. You will hold an integral role to the continued growth of CVS Health as a leader in the PBM MarketplacePay RangeThe typical pay range for this role is:Minimum: 75,400Maximum: 158,300Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications8 or more years of experience in managing operations/service delivery 2 or more years of experience managing complex Quality Assurance 3 years of testing experience within RxClaim or any other Adjudication System Willingness and Ability to travel up to 25% for project collaboration and stakeholder meetings Demonstrated ability to manage strategic projects Strong leadership experience is a must Knowledge of QA principles, practices and procedures and ability to apply this knowledge to a variety of work assignments and compliance initiatives Continuous process improvement mindset and the ability to turn improvement ideas into executable plans for implementation across QA/Application teams Strong team building, mentoring and coaching skills Experience with conflict resolution management and issues that may impede progress of delivery Proactive preparedness qualities surrounding government regulatory understanding and approach for change management Strong communicator, both verbal and written, with executive presence and the ability to influence across functions and at all levels of an organization. Highly organized and able to provide positive leadership across multiple work streams in a fast-paced, matrixed working environment. Ability to think both strategically and tactically, along with a willingness to challenge the status quo to ensure the department reaches higher levels of performance. Successful ability to prioritize, manages 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 and Facets also a plusCOVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred QualificationsDeep understanding in plan benefit configuration and testing 3- years experience working in Pharmacy Benefits Managment (PBM) industry/Managed care industry or Healthcare setting preferred Knowledge of RxClaim (AS400), EZQuery and EZTest tools Previous Test Automation experience developing automation frameworks and test scripts Excellent communication (Verbal and Written) and collaboration skillsEducationBachelor's degree is required preferably in Business, Finance or Business Analytics. Also consider degrees from other business and technical disciplines such as Computer Science, Information Systems, etc. Will consider equivalent work experienceBusiness OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Keywords: CVS Pharmacy, Irving , Sr MgrClient Ben Test, Other , Irving, Texas

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