Sr ConsultantThird Party

CVS Health Cumberland, RI
Job Description

The Senior consultant of Pharmacy Account Management will play a vital role in developing innovative, high profile process enhancements that will result in improved financial results and increased operational efficiencies. This role will have a profound impact on the future direction of the Pharmacy Account Management team through the creation of highly effective and sustainable system enhancements and process improvements. The person in this role will use advanced analytical skills and logic to prepare material and presentations for an array of audiences including senior leaders in a way that adds value, is easily understood, and improves the operational efficiency of the business. The ideal candidate will have strong analytical, communication, and independent leadership skills. In addition, the individual must be able to independently interact with and influence a wide range of stakeholders - including leadership - and demonstrate a consistent track record of delivering results.This role will be analyzing payment exceptions and other Accounts Receivable transactions, determining root cause, and making recommendations for process improvements. This role will be responsible for performing trend analysis, reviewing reporting,current procedures, identifying issues related to pharmacy plans, and recommending process improvements to improve team efficiencies. This role will assist in determining priorities of the team based on the analysis that is performed, with the goal of reducing bad debt, mitigating payment exceptions, and ensuring compliance.

Required Qualifications

* 1+ years of professional work experience required. Experience in retail pharmacy, PBM, banking/health insurance claims processing, or analyst experience strongly preferred.

* 1+ years of MS Office experience.

Preferred Qualifications

* Excellent analytical and root cause diagnosis skills with the ability to influence decisions by creating a strong case for action by leveraging analytical tools.

* Demonstrated success dealing with ambiguity or uncertainty and ability to learn on the fly to understand and solve new problems.

* Excellent verbal and written communication skills and the ability to interact professionally with a diverse group

directors, managers, colleagues, and external entities.

* Ability to influence decision by creating a strong case for action by leveraging analytical tools and root cause analysis.

* Proven track record constructing and executing complex analyses to meet business case requirements.

* Demonstrated ability to prioritize and organize work to accurately complete projects or assignments on schedule. - Ability to complete routinely assigned work based on productivity standards with minimal supervision.

* Strong problem resolution skills. Ability to work individually or within a team environment to systematically identify and define problems, evaluate alternatives, and implement practical, cost effective solutions.

* Solid working knowledge of all MS Operating Systems and MS Office applications (MS Word, Excel, Access, PowerPoint), and process mapping software such as Microsoft Project and Visio. Familiarity with Microstrategy and other data mining tools preferred.

* Ability to work in strict confidence, ensuring the confidentiality of the patient and medical and financial records at all times, in compliance with company and HIPAA Privacy guidelines.

* Flexibility to adapt to a changing environment, quickly making sound decisions.


Verifiable Bachelor's degree or equivalent experience required.

Business Overview

CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation's largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.

CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking Advice and Counsel

CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.

For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: