Implementation Specialist at CVS Health

Benefit Plan Implementation Manager

We're building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger helping to simplify health care one person, one family and one community at a time.

Position Summary:

Manages and coordinates benefit plan implementation for new and existing customers. Provides focused service fostering strong relationships with internal business partners to assure all group implementation and administrative updates are loaded correctly.

Fundamental Components:

Analyzes and determines if products and services selected by clients are aligned and can be adequately supported by existing systems or operating platforms; additionally, seeks solutions and negotiates essential requirements in support of any non-standard plan selections. Requires dynamic decision making to appropriately structure the group setups within the Meritain system to align with our vendor partners (PBM's, Managed Care Entities, etc..), analytics vendors and provide the required structure for client billing and reporting. Actively consults and communicates with internal staff regarding the details associated with new business and revision activity in a timely manner and validates account structure. Completes timely and accurate set-up of complex account structure and detailed benefit plans in systems for multiple constituents in order to satisfy both internal and external deadlines for production- impacting a wide variety of products and services. Monitors and manages internal installation process and maintains case tracking to meet constituents expectations and business goals. Maintains data files for monthly group reporting, assuring PHI guidelines are being followed. Runs monthly reports for all clients and brokers. Responds to escalated issues related to group setup. Assist with the development and testing of new or enhanced group setups. Provides technical expertise to team/unit, mentors junior staff members and assists with the development and implementation of training tools and processes. Runs adhoc data programs to assist with streamlining setup of group and eligibility files Runs adhoc data programs to quickly audit setup of customized group enrollments. Partners with our Products and IT teams with projects to add/enhance products and services. Point person for testing of all changes related to the ER/EO/GIM data files.

Required Qualifications:

1+ Year of experience in health care operations

Preferred Qualifications:

Previous experience in medical group implementation. Previous experience working with medical data files. Detail-oriented. Strong analytical skills. Excellent multi-tasking ability. Associate's degree or higher. Education High School diploma or GED

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range: The typical pay range for this role is: $46,988.00 - $112,200.00

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.