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As a Manager, Client Benefits - BRM - Audit SWAT for CVS Health, you will be responsible for researching and problem-solving adjudication and plan benefit issues, consulting with audit teams on proposed solutions, and building relationships with key internal partners to transform health care.
Job Responsibility:
Researching and problem-solving adjudication and plan benefit issues provided by the internal Audit team
Consulting with audit and other internal areas on proposed solutions to meet objectives and goals including financial and member experience
Researching and analyzing impacts for consideration of requirements or errors and providing direction on adjudication setups and solution to configuration and quality teams for mitigation
Building relationships with key internal partners through a consultative approach to understanding client benefit plan design needs
Translating client needs and requirements to internal CVS Health teams such as Benefits Coding and Quality Analysis
Facilitating meetings and presentations to provide status updates and make decisions relative to client benefit setup
Requirements:
At least 2 year of Benefit Relationship Management (BRM) experience
Experience with RxClaim adjudication
Bachelor's degree required, equivalent experience may be considered
Nice to have:
3-5 years of Benefit Relationship Management experience
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