As a BRM Advisor, you will be responsible for supporting, and managing benefit requirements for Medicaid government business for a large PBM client. The primary responsibility within this position is to interpret, analyze, and provide qualitative strategies that are in alignment with the overall plan design, and contracted turn-around delivery times that are currently in place for the Client.
• Serves as both a member of the team to deliver purpose built resolutions for the Medicaid Benefit Client Operations Team.
• Work cross-functionally with internal departments, such as clinical, networks, and IT to meet overall benefit requirement intended outcomes including custom client requests and state mandates.
• Building relationships with key client partners through a consultative approach to understand client benefit plan design needs.
• Translating client needs and requirements to internal CVS Health teams such as Benefits Coding and Quality Analysis, as well as analyze client benefit requests received through Sales Force and determine the best operational approach to coding and testing.
• Research, analyzing impacts for consideration of requirements or errors and providing direction on adjudication setups & solution to Configuration & Quality for mitigation.
• Develops new and/or reuses existing configuration through the use of program software and/or integrates enterprise programs that support client strategies.
• Performs research, problem resolution, and on-call support, according to defined plans or documentation for existing systems.
• Independently performs unit testing.
• May perform or assist with integration and system testing, according to detailed test plans to ensure high-quality systems.
• Independently works on multiple projects, and actively participates as a member of each project team supporting new programs introduced by the enterprise that supports the Clients structure.
• Performs reviews of all configuration built by other configuration SMEs.
• Facilitate and attend necessary internal and external meetings; presentations to provide status updates or intent strategy to the client and internal partners regarding benefit setup
The typical pay range for this role is:
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.
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• 2 or more years of experience in benefit plan design/coding/testing/account management, or related field
• Willingness and Ability to Travel up to 20% for client support if needed.
• Detail Oriented
• Resilient to change
• Customer focused
• Ownership and results driven
• Demonstrated ability to analyze data and determine conclusions
• Excellent verbal and written communication skills
• Bachelor's Degree is required; equivalent experience may be considered
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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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. 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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