Supervisor, Specialty Revenue Cycle Quality Assurance, CVS Health

CVS Health

Location:
United States, Monroeville

Category:
Customer Service

Contract Type:
Employment contract

Salary:

43888.00 - 85068.00 USD / Year

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Job Description:

CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area has an opportunity for a full-time Supervisor, Specialty Revenue Cycle Quality Assurance. Under direction of the Training and Quality Assurance Manager, this role assures consistent quality of Specialty Revenue Cycle functions to yield improved financial results for the Specialty line of business. The incumbent will be accountable for leading a team of auditors who, utilizing defined quality assurance processes, conduct work audits ensuring compliance with performance standards and partnering with training, analytics and process improvement functions to enable continuous improvement and elevate the entire quality assurance program.

Job Responsibility:

Oversees day-to-day operations of the team to ensure timely and accurate completion of all Quality Assurance (QA) activities, including completion of assessments and dispute resolutions
provides on-going feedback, Revenue Cycle process training, and acts as subject matter expert in addressing QA processes and procedures
Collaborates with QA Sr. Analyst to initiate, develop, test, and implement workflow and process efficiencies that help the department continue to automate and standardize output
Maintains the active QA roster of QA-eligible colleagues, including adding new hires, removing terminated colleagues, updating leaves of absence and other status changes
Plans and adjusts weekly and monthly production volumes and work scheduling to meet business expectations
Initiates and manages projects such as guidelines revisions and new department onboarding utilizing Revenue Cycle operations experience
sets and leads project meetings and provides meeting minutes and task assignments afterwards
Coordinates and collaborates with Revenue Cycle leadership to create effective collaboration and integration of QA Colleagues and business partners
Reports on performance results, disputes and resolutions, and other critical metrics to leaders
analyzes and uncovers trends in quality audits to identify individual and departmental challenges and partners with leadership and training team to foster continuous improvement and develop remediation activities
Creates a work environment for employees through team building, coaching, constructive feedback, work delegation, personal example and goal setting that encourages creativity, open dialogue on work issues, professional growth, and a consistent, high level of performance
encourages and supports employee decision-making within his or her scope of responsibilities
Completes regular individual check-in meetings
conducts formal and informal performance reviews for employees and provides timely feedback, coaching, and performance improvement plans as needed
Attends and participates in monthly Revenue Cycle Supervisor meetings
contributes QA updates as appropriate
presents Quality Assurance department overview to new leaders

Requirements:

2+ years of experience in a Supervisory or leadership role
1-2 years of Specialty Pharmacy Revenue Cycle Billing and Collections experience (Accounts Receivable, Accounts Payable, etc.)
MS Excel Skills: basic formulas, charts and pivot tables, filters, and editing spreadsheets
Must live within a 2-hour commute to the Monroeville, PA
High School Diploma or related work experience

Nice to have:

3+ years Revenue Cycle Management experience
1-2 years’ experience with medical benefits and 1-2 years’ experience with pharmacy benefits
Advanced Excel experience, including complex formulas, charts and pivot tables, conditional formatting, and data validation functions
Experience using the Microsoft Office Suite, specifically Excel, Teams, PowerPoint, Outlook and Word
Experience working with medical/pharmacy billing and reimbursement practices
Demonstrated analytical and problem-solving skills
Ability to effectively manage people and provide team leadership and engagement
Ability to evaluate work and process flow to ensure optimal efficiencies
Attention to detail and accuracy
Experience with Quality Assurance practices
Bachelor’s Degree preferred

What we offer:

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

Additional Information:

Job Posted:
May 23, 2025

Expiration:
June 20, 2025

Employment Type:

Fulltime

Work Type:

On-site work

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Supervisor, Specialty Revenue Cycle Quality Assurance