Sr. Manager, Member A/R and Disputes

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Position Summary

The Sr. Manager, Member A/R and Disputes requires an ambitious, motivated, and eager individual, looking to work for an industry-leading company.  This position is part of our PBM Financial Operations Member Experience department, a dynamic and skilled group, which manages all member-facing financial activities for CVS Health’s Caremark business.  The Sr. Manager will oversee all member A/R and collections activities for our mail order pharmacy along with member dispute resolution for mail order and the Medicare Prescription Payment Program (M3P).

Key Responsibilities:

-Lead the team and build relationships across departments to deliver on key enterprise initiatives

-Manage multiple projects with strict deadlines, delivering best in class service to stakeholders, and identifying business and client requirements associated with team/department deliverables

-Actively find solutions for resolving complex processes/requests through creative and sustainable solutions, identify opportunities to increase operational efficiency utilizing proven metrics, and initiate and lead projects which align to departmental goals.
-Functional accountability to oversee client relationships, member inquiry, vendor relationships, premium invoicing, application of payments, and reconciliation of payment functions

-Organize cross-functional teams to support larger organizational efforts; facilitating internal and external discussions to identify and/or resolve issues

-Identify opportunities for process improvements aligning with long-term organizational strategies

-Maintain high standards of compliance including adherence to policies and regulations set forth by government agencies including the Centers for Medicare and Medicaid Services (CMS)

This is a hybrid role requiring 3 days per week on-site at one of these locations: Northbrook, IL, Scottsdale, AZ, Irving, TX, Hartford, CT, or Woonsocket, RI. Additional CVS Health locations may be considered.

Required Qualifications

-7+ years experience in finance, billing, or a related field

-3+ years experience leading a team and developing talent

Preferred Qualifications

- Knowledge of SAP, S4, SalesForce, RxClaim, PeopleSafe, Compass and other Caremark specific applications

- Demonstrated ability to determine key business issues and develop appropriate action plans from multi-disciplinary perspectives

-Ability to quickly grasp a new subject and cultivate subject matter expertise to become a resource for all questions and requests related to this domain area within the department and organization

-Strong written and verbal communication skills

-Ability to manage through all levels of the organization

-Ability to function effectively in a high-volume, fast-paced environment

-Intermediate experience with Excel and Access

-Understanding of data fundamentals including developing and utilizing relational databases

-General knowledge of Medicare Part D

Education

- Bachelor’s Degree or equivalent work experience required

Pay Range

The typical pay range for this role is:

$75,400.00 - $174,200.00

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.  This position also includes an award target in the company’s equity award program. 
 
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,