Nov 11, 2019

Quality Assurance and Reporting Coordinator- 1137583BR

  • Professional Diversity Network
  • Spartanburg, SC, USA
Full-Time Retail

Job Description

CVS Health

Job Description
Job Summary:
Coordinate and oversee detailed reporting requirements for Clinical Intervention Centers. This includes gathering and analyzing reports, participating in meetings, and working closely with all CIC management to assure that processes are optimized.

Key Responsibilities:
* Strategize a schedule of core reports and activity around quality improvement and metrics review in conjunction with CIC management

* Perform QA/QI on various areas in the CIC- PSTI, coverage area including covered alternative letters and prior authorizations

* Collaborate with the CIC Management team to complete and respond to any audits.

* Work closely with the therapeutic interchange team to assure all interchanges are compliant.

* Support issues that arise in both the prospective and retrospective review of clinical claims.

* Support CIC managers by providing reports and assistance to help them manage their teams.

Required Qualifications
A minimum of 2-3 years of experience in a pharmacy. Must have strong healthcare experience. Must possess ability to analyze data and summarize as required. Ability to manage multiple projects simultaneously, adjusting priorities as needed and meeting deadlines. Must have good organization skills and the ability to problem solve. Must be proficient in Microsoft Office. Must have strong verbal and written communication skills and ability to work effectively cross-functionally with all levels.

Preferred Qualifications
Previous experience with long term care or rejected clinical claim resolution.

SC State Registration and Nationally Certified Pharmacy Technician

High School degree or equivalent.

Business Overview
It's 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 nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. As a CVS Health colleague, you'll 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.

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