CVS Health-posted 3 months ago
$92,700 - $185,400/Yr
Full-time • Mid Level
Richardson, TX
5,001-10,000 employees
Ambulatory Health Care Services

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. As part of the Rx Claim Adjudication team, you will be expected to be proficient in all critical functions of the application development and will champion SDLC methodologies with a deep understanding of best practices to ensure that quality standards are met. We believe for success you should have flexibility, possess a positive outlook, discernment, and inspire change within a fast-growing environment. This team directly impacts the lives of our pharmacy customers by creating systems that process prescriptions. The systems we work with process over 10 million scripts a day and is business critical. You can work knowing you are helping many people each day.

  • Oversee life cycle process (e.g., design, analysis, review) and testing results to ensure adherence to quality standards and deliver high-quality products.
  • Ensure consistent alignment of technical solutions with the business goals and objectives of the supported unit.
  • Perform model training, evaluation, and fine-tuning while considering the constraints and opportunities posed by legacy architectures.
  • Partner with teams and serve as cross-functional expert to provide bench-marked solutions to multiple, complex technical projects/initiatives using multiple interlocking technologies.
  • Establish and drive execution of technical direction, standards, guidelines, methodologies and advocate best practices.
  • Solve highly technical and complex problems for multiple projects and teams.
  • Develop and improve strategic and enterprise-wide technical direction.
  • Create or revise operating procedures relating to specific technologies or IS processes.
  • Lead assigned team projects and mentor junior resources as needed.
  • Possess problem solving and analytical skills that will help triage production support incidents and provide timely resolution while reducing MTTR.
  • Perform ITIL functions including but not limited to Incident, Change and Problem Management.
  • Perform incident trend analysis, Root cause analysis (RCA) and defect elimination planning.
  • 5+ years' experience and a deep understanding of AS/400 application development.
  • 3+ years of application development experience in RPG, RPGLE and CL.
  • 3+ years of IBMi SQL experience.
  • 3+ years of recent experience leading projects.
  • 7+ years of experience overall.
  • 1+ Synon2/E (aka COOL 2/E).
  • 5+ Year of Healthcare Experience.
  • Demonstrated successful completion of several medium to large scope projects; proficiency working on all phases of SDLC and with problem determination and resolution through research and fact finding.
  • Experience with RxClaim or other PBM Adjudication system is preferred.
  • Experience on Cloud Technologies like GCP, AWS, Azure, Java, Python and Angular.
  • 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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