Manager, Medicare Program Services Med D, CVS Health

CVS Health

Location:
United States, Work At Home

Category:
IT - Administration

Contract Type:
Employment contract

Salary:

60300.00 - 132600.00 USD / Year

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Job Description:

As an Audit and Testing Program manager, you will provide technical, analytical, and business support for all assigned programs for Medicare, Medicaid, and Commercial products. You will support CMS program audits, manage deliverables resulting from audit activities, and conduct year-round quality assurance testing to ensure smooth implementation of new programs and processes.

Job Responsibility:

Provide technical, analytical, and business support for all assigned programs for Medicare, Medicaid, and Commercial products
Support CMS program audits by delivering pertinent information in advance of audits
Manage deliverables resulting from audit activities including corrective action plans, issue narratives, and talking papers
Speak to Med D compliance and reporting documentation associated with clinical programs
Develop IT query writing and data analysis, business impact analysis, and root cause analysis
Present claims in RxClaim via live webinars with CMS and clients
Conduct year-round quality assurance testing for new programs, processes, and technology
Demonstrate validation of functionality for internal and external partners
Initiate corrective actions to resolve any issues

Requirements:

3+ years of Pharmacy Benefit Management, Medicare Part D or Medicaid experience
2+ years of in-depth knowledge of pharmacy products, services, and system capabilities
1+ years of project management or business analyst experience including the management of complex requirements
1+ Experience with the RxClaim software system
Developing and maintaining effective work relationships
Strong analytical skills and problem-solving abilities
Negotiation and conflict resolutions skills across various levels of an organization
Strong interpersonal communication skills using active listening and open-ended questions
Effective verbal and written communication skills
Ability to interact with various levels of an organization, including senior leadership
Ability to prepare and deliver presentations to clients
Ability to analyze large data files to find root cause
Attention to detail and accuracy
Highly organized and able to quickly prioritize multiple assignments
Exercise creativity and innovation in achieving project results
Bachelor's degree of equivalent experience

Nice to have:

Collaboration tools such as Microsoft Teams, OneNote, SharePoint 365, etc.
Reporting programs such as RxNavigator to review and develop reports
Microsoft Project software to create and maintain project plans

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
September 06, 2025

Expiration:
September 30, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Manager, Medicare Program Services Med D