Manager, Business Consultant - Federal Accounts

CVS Health•Work At Home-North Carolina, NC

22h•Onsite

About The Position

This role supports the Federal Employees Health Benefits Program (FEHBP) and Postal Service Health Benefits (PSHB) programs by leading and resolving complex projects, issues, and data analyses. The role partners closely with internal and external stakeholders to deliver client focused solutions, support profitable growth, ensure regulatory compliance, and maintain the overall effectiveness, competitiveness, and compliance of the self insured federal plans.

Requirements

5+ years of health insurance experience
3+ years of Project Management experience within the healthcare industry.
Strong problem-solving and decision-making skills, including the ability to assess risks and recommend effective solutions
Strong organization and project planning and management skills.
Proven ability to collaborate and work effectively within cross-functional teams
Experience and advanced knowledge of MS Office Suite applications, including Excel with the ability to use Pivot Tables for reporting

Nice To Haves

Experience working with the Federal Employees Health Benefits (FEHB) Program.

Responsibilities

Manage complex projects that advance the goals of self-insured federal plans, driving improvements in plan performance, operational effectiveness, and compliance.
Collaborate with internal and external stakeholders, including clients, senior management, and cross-functional teams, to ensure alignment of strategic objectives and support key business priorities.
Manage procurement activities for the team, including contract administration, vendor coordination, and invoice reconciliation to ensure accuracy, compliance, and timely processing.
Manage the annual LM 10 reporting process, ensuring accurate identification, tracking, and submission of all reportable employer–union transactions in compliance with Department of Labor requirements.
Manage network reporting for self insured federal health plans, including monitoring performance, developing and presenting client-facing insights, coordinating reporting and data validation, and resolving escalated network provider issues.
Support the annual prescription drug audit process, ensuring accurate validation of member coverage and compliance with plan requirements.
Manage assigned project activities independently, meeting timelines while proactively identifying and communicating risks that could impact milestones or outcomes.
Support additional projects and initiatives as needed to meet business priorities.