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CVS Health

Runs pharmacies, health plans and clinics

Associate Manager - Quality

Medical, Clinical & VeterinaryUpdated on Nov 9
Full-timePennsylvania, USARemote

About the Job

Requirements

  • Five or more years of Medicare Appeals background.
  • Experience with Microsoft Office.
  • Knowledge of Appeals job aids and workflows.
  • Strong communication skills, including the ability to provide and receive feedback.
  • Excellent time management skills.
  • Working knowledge of regulatory and accreditation requirements, benefit plans, and/or contractual arrangements.

Responsibilities

  • Oversee Quality staff, including organizing and developing high-performing teams.
  • Work with functional area managers to ensure consistency in monitoring and reporting activities.
  • Manage performance and resources for monitoring needs.
  • Build and maintain a solid team by selecting, training, coaching, and developing staff.
  • Collaborate to identify trends and recommend solutions.
  • Validate team effectiveness through scorecards and monitoring.
  • Facilitate and present at meetings within the Appeals team.
  • Accommodate team needs with a solutions-based approach.
  • Mentor the team on processes, problem resolution, and critical thinking.
  • Act as a liaison with other key business areas as needed.
  • Assist with developing and facilitating new training as needed.
  • Participate in hiring staff.
  • Create a positive workspace by recognizing team contributions, soliciting input, and assisting as needed.

Desired Qualifications

  • Two or more years of Quality experience.
  • Experience with QuickBase.
  • Training or leadership/management experience.
  • Knowledge of CMS guidance.
  • An associate degree.

About the Company

CVS Health

Runs pharmacies, health plans and clinics

CVS Health runs pharmacies, health insurance plans and medical clinics for individuals, employers and government programs across the United States. Its businesses include CVS Pharmacy, the Aetna insurer and Caremark, which manages prescription coverage and negotiates drug prices for health plans. Patients fill prescriptions in stores or by mail and receive care through walk-in clinics, primary care centers and home visits. The company earns money from prescription sales, insurance premiums, plan administration fees and clinical services, combining coverage with places to obtain treatment. Its first store opened in 1963, and its headquarters are in Woonsocket, Rhode Island.

Company size
10,001+
Company stage
IPO
Headquarters
Woonsocket, Rhode Island
Founded
1963

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