Claims Processing Manager

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
As a Claim Processing Manager, you will serve as a liaison between the business community and the Innovation Team to provide technical solutions to meet user needs. You will propose and assist in the development of new and innovative processes, through documenting requirements that reflect the value to clients, members, and CVS Health. This includes assisting in business process redesign and documentation as needed for new technology. You will also analyze business partner's operations to determine opportunities to automate processes and functions.

Key Responsibilities:

• Drive projects through lifecycle of the project by performing project management skills set.

• Determine level of effort of projects and estimation of work needed to ensure timely projects.

• Analyze moderate to complex projects through partnering with our clients and our developers to provide innovative solutions and process efficiencies that meet the clients’ intent and vision.

• Translate high level business requirements into functional specifications and manage changes to those specifications.

• Identify business, operational, and technical tasks, scope, time constraints and task inter dependencies.

• Lead walk through of business and functional requirements

• Work as a project team member or leader on multiple projects to facilitate process improvements (operational and technology centric) involving multiple sites or business areas.

• Coach and mentor new and existing Analysts, contractors, and full-time employees.

• Partner with internal and external departments on any potential issues discovered and ensure timely resolution of issues.

• Demonstrate strong sense of urgency and desire to succeed.

Required Qualifications

• 4+ years IT or Business experience in process methodologies and analytics

• 4+ years’ experience producing business requirements, process, and data flows.

• 2+ years’ experience working in Rally and Agile methodologies.

• Proven ability to train, mentor and coach others.

• Proven ability preparing and delivering presentations to all levels of management.

Preferred Qualifications

• Proven ability to manage and lead complex projects using project management skills and tools.

• Expert business analysis skill set.

• Proven ability to learn new processes and technologies.

• Proven ability to build effective working relationships with peers, leaders, and cross functional team members.

• Demonstrated success using interpersonal skills to negotiate priorities and resolve conflict among project teams.

Education
Bachelor’s degree or equivalent work experience

Pay Range

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.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.