CVS Health Hiring for Senior Manager, Client Clinical Operations at Minneapolis, Minnesota Full Time

Job Description

As a Senior Manager, Client Clinical Ops, you will be responsible for leading a team of Clinical Operation Advisors (COAs) and Benefits Relationship Managers (BRMs) for various lines of business. You will be responsible for driving the team to an accurate understanding and configuration of the clients formulary and utilization management programs. You will work closely with the internal benefits team and client to facilitate gathering formulary and utilization management requirements and designs the drug level set up for projects on the operations plan while ensuring compliance to internal best practice and federal and state guidelines.You will accomplish this by:- Understanding the clinical data analysis which will drive the design of the formulary and utilization management- Recommending and leading operational improvements both strategically and in the day-to-day application of organizational policies and procedures• Actively managing the performance of staff members to established performance standards• Working closely with Benefits Leadership, Account Management leaders, and the client.• Leading a team of pharmacists in clinical operation activities and driving the team to respond to testing defects, client questions, and benefits partners in a timely manner• Managing work flow and volume through salesforce to ensure team is meeting all deliverables• Coaching your team to identify and resolve challenges by analyzing information and figuring out appropriate solutions and driving to practical and creative solutions• Encouraging teamwork and a supportive departmental culture with an emphasis on ensuring outstanding client service• Monitoring business needs and developing documented processes and procedures as needed to build and maintain effective and productive workflowsYour success will be driven by the success of your team in their goals for exceeding quality metrics, turnaround times, as well as contributing to reduced service warranty payments to clients. Your healthcare industry knowledge, staff development and process improvement skills will also contribute to your success. You will operate in a dynamic environment with tight deadlines so your ability to operate autonomously and make key decisions is imperative. The contributions you will make will position CVS Health as a leader in client satisfaction and service in the PBM marketplace.This a fully remote, work from home role open to candidates anywhere within the United States.

Pay Range

The typical pay range for this role is:

Minimum: 107,250

Maximum: 231,000

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications

• Must hold active clinical licensure–RPh or RN- 4+ years pharmacist experience in the Pharmacy Benefit Management and/or Health Insurance industry from a operations perspective- 3+ years experience in a people management role, with direct accountability for goal setting and ensuring team deliverables and overall success- 1+ year using MS Word, Excel, Access and Outlook, with experience creating and updating Excel spreadsheets- Understanding of UM and Formulary- Must have the ability to travel up to 20% of the time

Preferred Qualifications

Intermediate or Advanced proficiency in MS AccessRXclaim experience preferrably RxClaim Coding and RxClaim Query/EZ Query experienceSalesForce.com experienceMedicaid Pharmacy Benefit ExperienceStrong interpersonal skillsAbility to comprehend statistical reporting and apply it to the operation of the department.Strong analytical skillsWorking knowledge of word processing, spreadsheet, workflow management applications.Demonstrate a clear understanding of company and client confidentiality.Adaptable to change while maintaining a positive attitude and being a strong role model for the team

Education

Registered Pharmacist or Nurse with active license in good standing requiredB.S. or Doctorate of Pharmacy degree or BS in Nursing is required

Business Overview

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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. 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.