CVS Health Jobs

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

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 (e.g., quality, accuracy and timeliness) and partnering with training, analytics and process improvement functions to enable continuous improvement. The Supervisor will also provide information to assist in the feedback and formal education process for Specialty colleagues.

Role Overview

• Hybrid role

What you will do

• 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 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; sets and leads project meetings and provides meeting minutes and task assignments afterwards.

• 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.

Required Qualifications

• 2 years of experience in a Supervisory or leadership role.

• 1-2 years of Healthcare Billing (Accounts Receivable, Accounts Payable, Collections, etc.) or similar Revenue Cycle experience.

• MS Excel Skills: formulas, charts and pivot tables, filters, and editing spreadsheets.

• Must live within a 2 hour commute to the Monroeville, PA office.

Preferred Qualifications

• 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.

Education

• High School Diploma or related work experience.

Pay Range

The typical pay range for this role is:

$40,600.00 - $85,100.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 07/04/2024

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.