Manager, Medicare Program Services, Med D

Description: As an Audit and Testing Program manager, provide technical, analytical, and business support for Medicare, Medicaid, and Commercial products including ESRD, Hospice, Transplant, Transition Fill and Part D Vaccine Administration.Support CMS program audits by delivering information in advance and communicate implications for successful audit experience.Research claims, read benefit setups in RxClaim, articulate risks or concerns, and manage deliverables from audit activities including corrective action plans, issue narratives, and talking papers.Speak to Med D compliance and reporting documentation associated with clinical programs; develop IT query writing and data analysis, business impact analysis, and root cause analysis.Present claims in RxClaim via live webinars with CMS and clients; conduct year-round quality assurance testing and validate functionality for internal and external partners to ensure smooth go-live for new clients. Requirements: 3+ years of Pharmacy Benefit Management, Medicare Part D or Medicaid experience2+ years of in-depth knowledge of pharmacy products, services, and system capabilities1+ years of project management or business analyst experience including the management of complex requirements1+ Experience with the RxClaim software systemDeveloping IT query writing and data analysis, business impact analysis; and root cause analysisAbility to interact with various levels of an organization, including senior leadershipPrepare and deliver presentations to clientsAnalyze large data files to find root causeTravel for business support less than 20% of the yearBe vaccinated for COVID-19Attention to detail and accuracyHighly organized and able to quickly prioritize multiple assignmentsExercise creativity and innovation in achieving project results 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. For more information, visit https://jobs.cvshealth.com/us/en/benefits Apply tot his job Apply To this Job