CVS Health Job - 32326950 | CareerArc
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Company: CVS Health
Location: Woonsocket, RI
Career Level: Mid-Senior Level
Industries: Retail, Wholesale, Apparel


Job Description
The Senior Advisor, Clinical Client Operations will be responsible for Enterprise RxClaim users on various projects, initiatives, and client requests related to Prior Authorizations to provide flawless experience to our customers and pharmacies. Conduct complex data analysis on large datasets and databases. Analyze findings and present results to CVS Health internal and external business partners to make informed strategic business decisions. Collaborate with various organizations and business partners to design inter-system interactions and implement PA processes that will span multiple technology systems ensuring that end to end process execution is flawless and error free. Perform complex root-cause analysis on issues faced by business and identify impact to health care members and clients in accordance with CMS guidance. Identify business requirements and provide solutions by assisting in automation to current technology and processes. Evaluate an assigned process or technology and processes. Evaluate an assigned process or technology and make recommendations to solve CVS Health or department business concerns. Utilize her Prior Authorization subject matter expertise to help the team implement, monitor and measure the quality of Prior Authorization overrides for various points of entry. Assist department customers to become knowledgeable and proficient in executing Prior Authorization overrides for various points of entry. Serve as a leader for various initiative and take the lead in PA related discussions or actions items related to cost savings. Develop and implement processes and tools to achieve established team goals. Develop and implement processes and tools to achieve established team goals and make professional presentations to CVS Health Senior Management. Provide weekly status and updates on projects to leadership and to escalate risks and issues as appropriate. Help define and maintain any department Policy and Procedures and Information Systems.

Required Qualifications
A Master's degree or foreign equivalent in Information Systems/Information Management Systems or a related quantitative field and 2 years of analytical skills experience working with large data sets for initiatives or trending opportunities. Must also have 2 years of experience in AS400 systems and SQL Server. Will accept a Bachelor's degree and 5 years of experience in lieu of a Master's degree and 2 years of experience. 10% Domestic Travel required. Telecommuting Available. Must apply by 7/24/2020.

Preferred Qualifications
Please see required qualifications.

A Master's degree or foreign equivalent in Information Systems/Information Management Systems or a related quantitative field. Please see required qualifications.

Business Overview
It's a new day in health care.

Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. As a CVS Health colleague, you'll be at the center of it all.

At CVS Health, we work every day to help people on their path to better health. Never has it been more important for us to deliver on our purpose to our valued customers, patients, members, and employees. With a presence in communities across the country, CVS Health colleagues are and will continue to be a critical piece of the country's health care solution. The health and safety of our employees, patients, customers, and members is our top priority as we face the impact of COVID-19 together. If you would like to learn about the actions we are taking as a company as we learn more about COVID-19 and its spread, we encourage you to visit our COVID-19 resource center at

We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.

CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. 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. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. Please note that we only accept applications for employment via this site.

We provide reasonable accommodations to qualified individuals with disabilities. If you need to request an accommodation, a qualified interpreter, written information in other formats, translation or other services, please contact our Advice and Counsel Reasonable Accommodations team by emailing Advice and Counsel Reasonable Accommodations team or calling 877-805-9511.

If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or For technical issues with the Virtual Job Tryout, contact the Modern Hire Help Desk at 1-877-451-1695 or

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