CVS Health

Northbrook, Illinois, United States

Quality Review Consultant

Posted over 1 month ago

Job Description

Job Description
The Quality Review Consultant will be responsible for auditing recently invoiced periods for variances and changes, validating those changes, assessing client impact, and then determining the potential and necessary corrections and process improvements. The role will focus on areas both upstream and downstream, and responsibilities will include completing thorough root cause analyses and corrective action plans, as well as performing quality initiatives, including policy and procedures and SOX and SOC-1 testing.

This position will interface closely with our Rebate Research, Claims, and Invoice teams to maximize resubmission opportunities, and to limit client service warranty payouts arising from incorrect invoice submissions.

Required Qualifications
* 1 or more years of performing in-depth research, investigation, analysis, ad-hoc reporting and/or related experience
* 1 or more years of experience using Microsoft Excel with the ability to work with large data sets

Preferred Qualifications
* Experience working with rebate invoicing, payments, reconciliations, or formulary research
* Experience working in a fast-paced, deadline-driven environment
* Deep understanding of CVS Caremark Benefit Design and Formulary
* Knowledge of pharmaceutical industry, drug products, and manufacturer rebate contracts
* Ability to query data via SQL and other data analytic tools
* Ability to establish and maintain collaborative relationships across functional units
* Proven problem solving and data analysis skills

Education
High school diploma/GED required. Bachelor's degree preferred.

Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.


We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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