Do you want to make a large impact in your next role? Join CVS Health, a Fortune 5 company as the Network Advisor. In this high impact role, you will support a team that are responsible for quality programs that drive quality initiatives.
You will develop and oversee process improvement initiatives, provide technical solutions, oversee team training and serve as a department subject matter expert in areas of network building and pharmacy pricing, including operational client support.
Here, you will have the opportunity to build and maintain a quality review process to ensure network pricing accuracy and compliance with our pharmacy network contracts. This role reports to the Sr Manager of Network Operations Quality.
Key areas of responsibility include:
- Developing, implementing, and maintaining business processes to ensure the correct composition of Medicaid networks based various State lists of registered pharmacy providers.
- Strategize, design, and lead a development project while working cross-functionally to gather client requirements.
- Responsible for quality assurance reviews of the process and developing a consistent, stable and repeatable process to maintain high quality/compliant networks.
- Daily focus is to ensure daily/weekly production files are processed timely and accurately.
- Client deliverables are met, data is accurate, regular maintenance is performed and programs are current.
To be successful in this role, you will need to be oriented toward relationship building, timeliness attention to detail, teamwork, and problem solving.
Join the company helping people on their path to better health! Our organization offers a competitive benefit package including vacation and holiday paid time off, health/dental/vision insurance, work/life balance, employee discounted stock purchase program, 401K, tuition reimbursement, and employee discounts at all CVS stores.
- 5 years experience in healthcare or pharmacy benefit management.
- Network Operations experience
- RxClaims knowledge and experience.
- Bachelor's Degree Preferred
Verifiable High School diploma or GED is required.
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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