CVS Health Job - 45048647 | CareerArc
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Company: CVS Health
Location: Harrisburg, PA
Career Level: Associate
Industries: Retail, Wholesale, Apparel

Description

Job Description
This position can be WFH or hybrid (in any CVS office).

This Lead Dir, Financial Planning& Analysis will oversee many of the areas the handle the financial relationship with CMS concerning all the Part D plans at CVS Health, Aetna, and our Duals programs.

This will include, but not be limited to
- Plan to Plan monthly settlements and annual reporting
- Coverage Gap Discount Program quarterly invoicing
- DIR submissions to CMS
- Payment Reconciliation and Settlements with CMS
- CMS Reconciliation / Reopener models for all open years
- Audit and PDE reserves
- PDE audits by CMS, OIG, and other federal agencies
- CMS financial (one-third) audits
- Oversee operation and compliance of the Automated TrOOP Balance Transfer, facilitating daily unresolved reports, as well as handling manual requests

This position also be responsible for
- Overseeing PDE submissions and responses by Caremark (our PBM) to CMS, including regular monitoring of rejects and exclusions, regular reporting on results to management, and ensuring resolution to maximize the plans settlements.
- Overseeing a multitude of reporting internally and from CMS.
- Monitor and authorize payment of open member balances, retro-hospice, retro-ESRD, and other CMS required adjustments.

Pay Range
The typical pay range for this role is:
Minimum: 100,000
Maximum: 227,000

Please 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 Qualifications
- 8+ years Insurance experience
- 5+ years Medicare experience, preferably Part D
- 5+ years Finance/accounting experience
- Management experience, preferably of other managers

Preferred Qualifications
- Medicare Part D experience with financial arranagements
- IT and data warehousing

Education
Bachelors degree or equivalent experience.

Business Overview
Bring your heart to CVS Health Every 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. 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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