Benefits Design Senior Advisor (Tucson)

CVS Health in Tucson, AZ

  • Industry: Scientific Research - Health/Medicine/Pharmacology
  • Type: Full Time
  • $47,060.00 - 69,930.00
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Job Description As the Benefits Design Senior Advisor you will have the overall responsibility for the Benefit Design within the Heath Plan Market Segment for Medicare/Medicaid/Commercial/Exchanges line of business. You will need to bring with you a strong technical knowledge to focus on the roll out of automation strategies. Your focus will be responsible for driving the development of an automated approach to automate the creation of client benefits through a business rule engine. You will also be responsible for the overall communication to leadership on the status and overall quality of Design for the Health Plan Client Services Team. Your role will entail proactive planning, effective communication, coordination and project management of select organizational initiatives, action tracking and follow-up, and coordinating benefit automation projects in support of the business unit. You will be responsible for ensuring organizational processes are optimally aligned and coordinated between groups and projects. Some of your key tasks will include: - Independently making decisions by applying sound judgment based on business principles and supporting data facts - Inspiring change through the organization - Driving high level automation solutions - Training and mentoring members of the team on technical and automation concepts, initially regarding business rule engines - Collaborating with technical teams to design, develop and drive automated solutions to support business processes Focus areas include collaboration with partner organizations like IT and Clinical Client Services to create standard methodologies, design templates, quality improvement, procedures, workflow management, and increase level of automation. You will act as an authority to gather and coordinate automation requirements, support and analyze requests from the requirements teams, translate client requirements into our adjudication system, staff training documentation and policy and procedure documentation. You will collaborate with internal partners, peers and staff to ensure all work is done accurately and on time. Your success will be measured by your ability to effectively communicate and collaborate with key partners and deliver your projects/assignments across the finish-line. You will operate in a dynamic environment with tight deadlines. Your ability to resolve ambiguous requests will also contribute to your success. Required Qualifications * 8+ years of experience in PBM adjudication functionality and plan design * 4+ years of proven project leadership experience, with ability to work in a dynamic team environment while meeting deadlines * Ability and Flexibility to Travel up to 20% is required Preferred Qualifications * Advanced knowledge and experience in RxClaim Adjudication is strongly desired * Benefit Builder experience strongly desired * Ability to work effectively across several functional business areas * Experience working in a client facing role * Must be disciplined in operational excellence with the ability to drive improvements, optimize the organizations performance and instill accountability for quality * Demonstrable experience fostering a strong, consultative workforce Education * Bachelor's degree is required * Equivalent work experience may substitute Business Overview Its a new day in health care. Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nations premier health innovation company. Through our health services, insurance plans and community pharmacists, were pioneering a bold new approach to total health. As a CVS Health colleague, youll be at the center of it all. We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability. CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran we highly value and are committed to all forms of diversity in the workplace. 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. 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 . We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team . Please note that we only accept applications for employment via this site. If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-###-#### or ...@us.ibm.com . For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-###-####.
Associated topics: antibody, cytometry, dietary, histotechnologist, immuno oncology, industrial hygienist, nutritionist, physiology, therapeutic, virus
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