As the Clinical Operations Manager for Specialty you will be responsible for providing operational leadership and direction for commercial, Medicaid, and Medicare specialty setup requests. Your team of 10 - 12 Clinical Coders will have a primary focus on Specialty Rx Coding operations requests related to the RxClaim Specialty Rx module. Your responsibilities will also include:
- Leading, Coaching, and mentoring your team
- Collaborating with other leaders within this team
- Partnering with key internal and external clients
Your success in this role will be determined by your ability to keep your team performing to a high standard in a dynamic environment. You will need to bring your skills in quality improvement,procedures development and workload management. In addition to your operational oversight, your workload will include assisting your team in translating client requirements into meaningful actions for your team as well as transformational and policy and procedure development and documentation. Meeting deadlines in this role is an imperative. As the Clinical Operations Manager, you will be seen as a leader and a problem solver, and you will have a significant impact on CVS Health maintaining our position as a leader in the Pharmacy Benefit Management space.
* 5+ years of experience in RxClaim adjudication functionality and plan design, including knowledge and understanding of
RxClaim Specialty Rx Module and Functionality
* At least 3 years of direct or indirect leadership experience
* Some minimal travel may be required for business support
* Demonstrable experience working with Salesforce.com
* Ability to thrive in a fast-paced environment
* Deep understanding of the complex healthcare and PBM Industry
* Experience in developing cross-functional relationships
* Strong Client interaction skill-set and experience
* Verifiable High School diploma or GED is required.
* Bachelors Degree is strongly preferred
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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