Job Description
Job Description
This is a full time telework position. Qualified candidates may reside in any state (US). The Senior Project Manager is accountable to assure encounter error inventory for multiple state(s) are reviewed/resolved and corrected according to state/federal regulations. Responsible for strategizing root cause analysis of pharmacy encounter errors, inventory management and setting priorities while executing towards department goals and metrics.
Required Qualifications
* Develops and implements strategic project plan to achieve business goals.
* Proactively leads project and/or business by setting direction of project, creating project plan, timeline identifying key milestones and additional resources needed on selected project(s).
* Liaison between Aetna SO, Pharmacy Directors, Formulary Coding team and CVS teams for all MCD Health Plans->drive standard work across all markets.
* Encounter reject research and resolution with CVS vendor where outcome may be formulary coding update, enrollment, reference file related
* Implementations, biweekly CVS ops/recon calls
* Contractual compliance and regulatory changes oversight for all plans->execute Service Warranties for encounter issues/penalties associated with CVS submission
* Change Requests oversight
* Solicits and evaluates internal and external customer feedback to enhance continuous quality improvement.
* Identifies issues that may stall project and addresses them by either resolving the issue or creating an alternative solution.
* Tracks progress and communicates project(s) status on a regular basis to all impacted parties.
* Builds communication plans for implementation to ensure all impacted parties (upstream/downstream) are informed of next steps for completion.
* May mentor and/or manage others.
* Acts as an advocate for change may require influencing others to see the value in project, including managing interpersonal sensitivities and articulating the strategic view to ensure project alignment.
Preferred Qualifications
* Solid Project Management and supervisory skills.
* Proven ability to affect change/interpersonal skills.
* Past positions required acting a project lead and directing a team.
* Proven communication skills both written and verbal.
* Proven track record in meeting project milestones and negotiating for resources.
* Demonstrated proficiency with personal computer, keyboard navigation skills and with MS Office Suite applications.
Education
* 5-7 years of management experience related to standards & measurements, technology, systems, processes, etc. preferred.
* Ability to communicate effectively with all levels of management.
Business Overview
At Aetna, a CVS Health company, 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.
This is a full time telework position. Qualified candidates may reside in any state (US). The Senior Project Manager is accountable to assure encounter error inventory for multiple state(s) are reviewed/resolved and corrected according to state/federal regulations. Responsible for strategizing root cause analysis of pharmacy encounter errors, inventory management and setting priorities while executing towards department goals and metrics.
Required Qualifications
* Develops and implements strategic project plan to achieve business goals.
* Proactively leads project and/or business by setting direction of project, creating project plan, timeline identifying key milestones and additional resources needed on selected project(s).
* Liaison between Aetna SO, Pharmacy Directors, Formulary Coding team and CVS teams for all MCD Health Plans->drive standard work across all markets.
* Encounter reject research and resolution with CVS vendor where outcome may be formulary coding update, enrollment, reference file related
* Implementations, biweekly CVS ops/recon calls
* Contractual compliance and regulatory changes oversight for all plans->execute Service Warranties for encounter issues/penalties associated with CVS submission
* Change Requests oversight
* Solicits and evaluates internal and external customer feedback to enhance continuous quality improvement.
* Identifies issues that may stall project and addresses them by either resolving the issue or creating an alternative solution.
* Tracks progress and communicates project(s) status on a regular basis to all impacted parties.
* Builds communication plans for implementation to ensure all impacted parties (upstream/downstream) are informed of next steps for completion.
* May mentor and/or manage others.
* Acts as an advocate for change may require influencing others to see the value in project, including managing interpersonal sensitivities and articulating the strategic view to ensure project alignment.
Preferred Qualifications
* Solid Project Management and supervisory skills.
* Proven ability to affect change/interpersonal skills.
* Past positions required acting a project lead and directing a team.
* Proven communication skills both written and verbal.
* Proven track record in meeting project milestones and negotiating for resources.
* Demonstrated proficiency with personal computer, keyboard navigation skills and with MS Office Suite applications.
Education
* 5-7 years of management experience related to standards & measurements, technology, systems, processes, etc. preferred.
* Ability to communicate effectively with all levels of management.
Business Overview
At Aetna, a CVS Health company, 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 are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. 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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