BA PCL Team

Job Description

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Job Group Summary:

Management professionals develop and implement strategies and policies to direct our operations, subsidiaries, major projects and functional groups.  They help our business units and our company  meet corporate objectives and compete more successfully in the marketplace.

Position Summary/Mission:

Supports Prior Carrier Load (PCL) Team   by working with the manager in achieving Meritain Health purposes and objectives by contributing to solving management and business problems, identifying, and seizing new opportunities, building strategic partnerships, and implementing change. Responsible for providing analysis, guidance, and direction within areas of expertise; and developing relationships with cross-functional team members as required in support of Meritain Health onboarding initiatives, with a special focus on streamlining of processes.  Develops, executes, and monitors the new process/changes and monitors implementation activities and team workload assignements.  Addresses problems of a short to mid-term nature independently and address longer-term issues with limited supervision.  May oversee assigned small scale cross-enterprise initiatives and concurrently serve as a team member on cross-functional initiatives based on direction from direct leader.  Provides direct support to the PCL team and addresses complex PCL issues for resolution.

Fundamental Components & Physical Requirements:

• Address entry of enhancements and testing for our PCL Team
• Address adjustment research for clients that have required retro load changes
• Gather information for the annual SOC audits
• Research any Settlement Auth questions
• Coordinate monthly reporting activities
• SME for Salesforce enhancements
• Point person for creating and editing P&P updates
• Analyzes and determines load requirements for the clients are aligned and can be adequately supported by the files received.  Seeks solutions and negotiates essential requirements in support of any non-standard file loads. Requires dynamic decision making to appropriately structure the load setups within the Meritain system to align with our internal partners and meet the Client needs.
• Consults and communicates with internal staff regarding the details associated with data files in a timely manner and validates account structure.
• Completes timely and accurate set-up in systems in order to satisfy both internal and external deadlines for production impacting services.
• Monitors and manages internal installation process and maintains case tracking to meet constituents expectations and business goals.
• Support the PCL team by handling day to day work as needed to meet business needs.

Background Experience Desired:

• Experience with moderate scale initiatives with moderate degree of complexity.
• 3+ years experience with healthcare benefit administration services.
• Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.
• Demonstrated superior business process, project management and organizational redesign experience.
• Demonstrated experience successfully implementing change in complex organizations.
• Operational experience in a relevant discipline.
• Microsoft office, particularly excel, experience.

Education and Certification Requirements:

• College degree or equivalent healthcare operations experience
• Appropriate licensure or certification by discipline preferred.

Additional Information:

• Team leadership and team building skills.
• Analytical and planning skills.
• Negotiation/influencing skills.
• Relationship and change management skills.
• Organizational skills.
• Time management skills.
• Critical thinking skills.
• Oral and written communication skills.

Pay Range
The typical pay range for this role is: $43,700.00 – $107,200.00.

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. 

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.