Manager, Client Benefits - Transforming Healthcare through Innovative Benefit Testing and Client Services

Bringing Our Heart to Every Moment of Your Health at CVS Health At CVS Health, we're driven by a singular purpose: to bring our heart to every moment of your health. This guiding principle is at the core of everything we do, from delivering enhanced human-centric healthcare to fostering a culture that empowers our colleagues to make a meaningful difference. As a leading healthcare organization, we're committed to innovation, customer satisfaction, and community well-being. If you're passionate about making a positive impact in the healthcare industry, we invite you to explore this exciting opportunity to join our team as a Manager, Client Benefits. About the Role We're seeking a dedicated and experienced Manager, Client Benefits, to lead our Client Benefit Services QA team. As a Benefit Testing Manager, you'll play a critical role in driving success across multiple functions, including Clinical and Benefit Organization. Your expertise will be instrumental in solving complex problems, improving processes, and increasing automation opportunities within our testing team. This is a remote role, offering the flexibility and freedom to work from anywhere while making a significant impact on our organization. Key Responsibilities Serve as a subject matter expert for testing client benefit plan designs in Utilization Management and Formulary, presenting test results to internal benefits teams and external clients. Translate client needs and benefit requirements into test scenarios to validate benefit configuration and benefits coding, leveraging your expertise in EZTEST, Sales force, EZQUERY, EXCEL Macro, Formulary management system, and Benefit Serve/Benefit builder. Develop and execute test plans, capture test results, and present findings to stakeholders, ensuring benefit configuration accuracy and client satisfaction. Facilitate internal and external meetings, providing status updates and ensuring seamless communication among stakeholders. Build strong relationships with key client partners through a consultative approach, understanding their benefit plan design needs and delivering tailored solutions. Assess project risks, provide risk mitigation plans, and develop process improvement initiatives to drive department efficiency. Identify areas for improvement, pinpoint training needs, and advise colleagues on benefit testing processes and best practices. Propose and develop testing automation tools to enhance testing accuracy and rapid turnaround, driving innovation and excellence in benefit testing. Essential Qualifications To succeed in this role, you'll need: A minimum of 5+ years of experience in Healthcare/PBM, with a strong background in Formulary Management, Drug Utilization Management, and Claims Adjudication. Excellent communication (verbal and written) and collaboration skills, with the ability to work effectively with diverse stakeholders. Demonstrated ability to manage and organize projects from start to completion, with a strong analytical and problem-solving mindset. Computer proficiency in MS Office applications (Microsoft Word, Microsoft Excel, Microsoft PowerPoint, and Microsoft Outlook). Expertise in defining benefit test conditions, with hands-on experience in EZQUERY/Sequel and claim processing tools like EZTEST. A bachelor's degree or equivalent experience, with a strong foundation in healthcare or a related field. Preferred Qualifications While not mandatory, the following qualifications can enhance your candidacy: Experience with Medicaid state-specific benefit programs and knowledge of CMS and state mandate benefit programs. Ability to coach, train, and mentor resources with benefit testing processes, with a strong leadership and development mindset. Familiarity with Sales force and Benefit Serve/Benefit builder, with a willingness to learn and adapt to new technologies and tools. What We Offer At CVS Health, we offer a comprehensive rewards package that includes: A competitive salary range of $60,300 - $132,600, with opportunities for bonuses, commissions, or short-term incentives. A full range of medical, dental, and vision benefits, ensuring you and your family's well-being. A 401(k) retirement savings plan and Employee Stock Purchase Plan, helping you plan for the future. Numerous well-being programs, education assistance, and free development courses to support your growth and well-being. A CVS store discount and discount programs with participating partners, making it easier to live a healthier lifestyle. Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year, allowing you to recharge and relax. Our Culture and Work Environment At CVS Health, we're committed to fostering a culture that is inclusive, collaborative, and empowering. Our Heart At Work Behaviors guide our interactions and decision-making, ensuring we're always putting our heart into caring for our colleagues and communities. As a remote team member, you'll be part of a dynamic and flexible work environment that values work-life balance and supports your professional growth. Career Growth and Development As a Manager, Client Benefits, you'll have opportunities to grow and develop your skills in a rapidly evolving healthcare landscape. You'll be part of a talented team that is passionate about delivering exceptional client services and driving innovation in benefit testing. With CVS Health, you'll have access to: Training and development programs to enhance your skills and expertise. Opportunities for career advancement and professional growth. A collaborative and supportive work environment that encourages innovation and creativity. Join Our Team If you're a motivated and experienced professional looking to make a meaningful impact in the healthcare industry, we invite you to apply for this exciting opportunity. As a Manager, Client Benefits, you'll be part of a talented team that is shaping the future of healthcare. Don't hesitate - apply today and take the first step towards a rewarding career with CVS Health! We value a great attitude and a willingness to learn above all. If you don't meet every single requirement, we still encourage you to submit your application. We're committed to creating a diverse and inclusive workplace, and we're excited to hear from you. Apply for this job