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.
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.
Required Qualifications
- 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
Preferred Qualifications
- 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
Education
Bachelor’s degree in a closely related field or an equivalent combination of formal education and recent, related experience
Please replace this section with the Education Requirements
Pay Range
The typical pay range for this role is:
$67,900.00 - $182,549.00
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. This position also includes an award target in the company’s equity award program.
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.
For more detailed information on available benefits, please visit Benefits | CVS Health
We anticipate the application window for this opening will close on: 03/01/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Top Skills
What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners.
Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
