Job Description Do you want to make a large impact in your next role? Join CVS Health as the Network Senior Advisor, which will support Anthem. In this high impact position, you will lead projects that are responsible for enrolling new pharmacy providers into networks, building and maintaining client custom networks, ongoing maintenance of our provider network and issue research and resolution.
You will be accountable for a high volume of requests, most of which require subject matter expertise on our systems, claims adjudication, network pricing and client network set-ups. This role will require building partnerships with other business units as well as key external business partners You will interface with Anthem to help design operational solutions to meet their business needs.
The Senior Advisor reports to the Director of Network Operations and will take ownership of building and maintaining a quality review process to ensure network pricing accuracy and compliance with our pharmacy network contracts.
To be successful, 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.
Required Qualifications - 10 years of professional work experience required. - Minimum of one year of contract review and claims research experience required.
Preferred Qualifications - RxClaims knowledge and experience preferred. - Health care and or pharmacy benefit management experience preferred.
Education - Bachelors degree required.
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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