About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary To be successful in this position, the candidate must have demonstrated experience in Medicaid and Medicare, including health plan operations, understanding benefits, regulatory requirements, and annual readiness. The successful candidate will have a demonstrated ability to work in a highly matrixed organization and proven success in such an environment. In partnership with and under the direction of the Lead Director, Health Plan Market Operations, this position will help develop and maintain processes for the management, execution, and oversight for all operational functions including benefits, claims, materials, clinical, finance to ensure SNP program requirements are met. This role will support and/or lead operational calls, plan leadership meetings and cross functional meetings to drive coordination of operational activities for product success.

Requirements

  • At least 5 years of Medicare Advantage product experience
  • Strong interpersonal and communication skills, including the ability to interact and influence at various levels of the organization.
  • Ability to work independently and to recognize and resolve issues.
  • Strong analytical and problem-solving skills
  • Knowledge of Medicare and Medicaid program requirements
  • Operational background within a health plan environment, including regulatory requirements
  • Demonstrated ability to effectively coordinate multiple projects simultaneously

Nice To Haves

  • Experience with integrated dual products
  • Experience working and communicating with cross functional teams for operational management
  • Proficient in Microsoft Office STE, One Note & Teams
  • Experience working in a heavily matrixed environment

Responsibilities

  • develop and maintain processes for the management, execution, and oversight for all operational functions including benefits, claims, materials, clinical, finance to ensure SNP program requirements are met.
  • support and/or lead operational calls, plan leadership meetings and cross functional meetings to drive coordination of operational activities for product success.

Benefits

  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service