Job Description As a Benefits Quality Analysis Rep II, you will be part of an extremely talented team within our Client Benefits Quality department at CVS Health. You will be responsible for analyzing client requests and performing the necessary benefits testing and quality assurance. You'll work alongside other Benefits Coders, Testers, and Quality Assurance Representatives, as well as our Account Management and Implementation teams to deliver high quality support to our vast number of clients. Extreme attention to detail is important for this role, as your testing and quality assurance activities will impact not only the commercial clients at CVS Health, but the federal and state programs that we participate in, such as Medicare Part D and Medicaid.
This is a fantastic opportunity to start your career in the Pharmacy Benefit Management industry, as extensive training will be provided.
Required Qualifications - 2+ years of Testing and QA experience - 1+ years of experience within the Healthcare Industry
Preferred Qualifications - Experience with RxClaim Software - Previous work experience in a PBM, Medical Claims, Health Insurance, Pharmacy, or Benefits highly preferred. - Provide leadership and identify opportunities to improve efficiency/quality - Able to deliver per the timelines - Effectively participate in RCA's and apply the 5-Why process - Work large / complex clients to ensure 100% test coverage and review for proper set-up that meets client intent - Mentor and coach other team members - Proficient use Microsoft Office applications, e.g. Excel, Word - Project Management skills - Responsible for maintaining your SalesForce.com (SFDC) queue at all times - Regression Testing, Query Testing and AS400 experience preferred
Education Verifiable High School Diploma or GED required, Bachelor's degree is preferred
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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