Membership Operations Analyst

2 weeks ago

Phoenix, United States CVS Health Full time

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**
This position will be responsible for managing a book of business and representing the Integrated Accumulations Department for CVS/Caremark when working with the assigned Medical Partners/Vendors. This Analyst will be accountable for interactions with that the assigned medical partner/vendor. This Analyst will be responsible for overseeing the transactions shared between the Medical Partner and CVS/Caremark.. When there are transaction errors, this Consultant will be responsible for resolving those errors either internally or with the help of the Medical Partner. In resolving the transaction errors, this Analyst will be required to investigate and research the source of the error and correct it by using the Department’s standard processes and tools. It may also require the Analyst to partner across work streams with other internal resources to ensure the errors are corrected in a timely and efficient manner. This may include representing Integrated Accumulations on cross-functional work teams to resolve specific client issues.

This Analyst will be responsible for meeting operational metrics and providing results for their book of business to the department leadership. Lastly this Analyst will be responsible for implementing service for new clients with existing Medical Partners. This will require the Analyst to work with cross-functional Implementation teams to setup and configure the sharing of transactions within the project plan timeline.

PRIMARY DUTIES AND RESPONSIBILITIES: List the top four or five primary responsibilities of the position in the space provided below, indicating the most important functions first and the approximate percentage of time spent on each.

Responsibilities % Time
1.Planning, organizing, guiding and tracking all work associated with the assigned book of business, ensuring all metrics for assigned book of business are met. 30%
2.Establishing and building effective relationships with the assigned medical partners. 20%
3.Ensuring all issues and errors are resolved using the department operating standards and within standard turnaround times. 30%
4.Implementing new clients as assigned. 20%

**Required Qualifications**
1. 1+ years of related professional work experience, Healthcare or PBM preferred
2. At least 1 year of experience managing a collaborative relationship, either with internal or external partners.
3. 1 or more years of experience using data to solve problems and/or process issues
4. 1 or more years of advanced Microsoft Excel experience.

**Preferred Qualifications**

1. Strong attention to details and ability to find root cause of issues.

2. Ability to analyze and provide resolution to routine business and process issues.

3. Ability to collaborate and partner with teams across the PBM and medical partners to guide resolution to issues and requests.

4. Ability to operate effectively in a large, complex, and diverse organization. All 5. Skilled in focusing on desired results, determining and prioritizing what is important and urgent, clarifying next steps, and escalating issues effectively to meet deadlines and achieve desired results

6. Ability to adhere to the highest ethical standards including honesty, integrity, dedication.

7. Ability to use Microsoft Suite of products including Word, PowerPoint, Excel, SharePoint, Visio, Project, etc.

8. Experience with health care, pharmacy benefit management, integrated accumulations, a plus.

9. Operate in a highly complex, matrix, and fast changing environment. This includes managing a book of business that will not be predictable.

10. Work directly with internal partners at all levels (may include benefits, testing, account management, etc)

11. Ability to prioritize work, execute work assignments to ensure deadlines are met, and identify when deliverables are at risk of not being met.

12. Support and adapt to organizational change when required

13. Healthcare or PBM preferred

**Education**

Verifiable High School Diploma Required, Bachelors Degree or Equivalent Work Experience preferred.

**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 thi

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