CVS Health

Northbrook, IL

Manager of Adjudication Solutions

Posted over 1 month ago

Job Description

Job Description
As the Manager of Adjudication Solutions, you will act in the role of lead project facilitator for the team and across departments. You will coordinate across departments adjudication projects and development ensuring consistency in all deliverables. You will also be responsible for facilitating, defining and documenting prescription benefit and clinical requirements for Client Services projects and delivering key functionality and set-up. Your projects will be geared toward operational efficiencies in the Client Requirements, Automation and Client Implementation as well as support of other operational needs and issues. Your collaboration and partnership with the appropriate departments including information services department when needed. Your responsibilities will include:

- Leading adjudication business analysts and production support resources

- Defining the procedures and policies on developing adjudication related projects

- Implementation and rollout of new functionality

Required Qualifications
5 + years of experience in Business Analysis

Preferred Qualifications
RxClaim knowledge
Salesforce
SQL
Prior management experience

Education
Bachelor degree or work experience equivalent

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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