Pharmacy Benefit Manager Operations Specialist
About The Position
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. This Pharmacy Benefits Manager Operations Specialist is a member of Meritain Health PBM Operations Team, and is responsible for collaborating with Implementation Managers, Pharmacy Implementation Managers, various external PBM vendors, and clients, in order to implement the following files to be used for invoice processing and member accumulators: eligibility, accumulators, invoices, and claims detail. The Pharmacy Benefits Manager Operations Specialist is the liaison between Meritain and the PBM vendors to which they are assigned. In this role, you will: Meet with PBM (Pharmacy Benefit Manager) vendors and groups to complete new group and renewal group implementations. Set up new group and renewal group implementations in the system based on selected PBM vendor with data elements, field mapping, naming conventions, file feed locations, platform, and back-end vendor. Coordinate and conduct IT (Information Technology) related activities such as ticket submissions and testing. Notate tasks and relevant dates for new group and renewal group implementations within Salesforce. Ensure that new group and renewal group implementation tasks are completed, file receipts confirmed, and hand off sheet routed to Invoice Processor team. Support escalations with a sense of urgency, regularly communicate with stakeholders, and see various processes through to completion.
Requirements
- 2+ years of healthcare industry and/or PBM vendor experience.
- Proficiency with Microsoft desktop software applications, such as Outlook, Word, and Excel.
Nice To Haves
- 1+ year of experience working for an Rx company.
- Previous experience utilizing Salesforce.
- Ability to work efficiently in a team-based environment.
- Strong attention to detail.
Responsibilities
- Meet with PBM (Pharmacy Benefit Manager) vendors and groups to complete new group and renewal group implementations.
- Set up new group and renewal group implementations in the system based on selected PBM vendor with data elements, field mapping, naming conventions, file feed locations, platform, and back-end vendor.
- Coordinate and conduct IT (Information Technology) related activities such as ticket submissions and testing.
- Notate tasks and relevant dates for new group and renewal group implementations within Salesforce.
- Ensure that new group and renewal group implementation tasks are completed, file receipts confirmed, and hand off sheet routed to Invoice Processor team.
- Support escalations with a sense of urgency, regularly communicate with stakeholders, and see various processes through to completion.
Benefits
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
