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Job Details

CVS Health

Quality Review Process Manager





Northbrook, Illinois, United States

Job Description
The Quality Review Process Manager will be the subject matter expert on all processes related to auditing rebate invoice data, and will help lead both the root cause analysis and corrective action plan processes. Responsibilities also include performing quality initiatives, including documenting processes, policies, and procedures in adherence with internal controls.

This position is also responsible for the development of a team of analysts. Duties include thorough onboarding and training of all new hires, providing ongoing coaching and feedback, and delegating work among team members. It will also be responsible for leading the successful roll out of new initiatives, process improvements, and projects.

This position will interface closely with our Rebate Research, Claims, and Invoice teams in order to maximize resubmission opportunities, and limit client service warranty payouts arising from incorrect invoice submissions. It will also engage with and collaborate with key personnel and leaders from other functional areas, including Client Audit, Finance, Accounting, Trade, Underwriting, and Account Management.

Pay Range
The typical pay range for this role is:
Minimum: 60,300
Maximum: 126,600

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications
3 or more years of PBM and/or Training Experience

COVID Requirements

COVID-19 Vaccination Requirement
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.

Preferred Qualifications
Experience working with rebate invoicing, payments, reconciliations, or formulary research
• Experience working in a fast-paced, deadline-driven environment
• Deep understanding of CVS Caremark Benefit Design and Formulary
• Knowledge of pharmaceutical industry, drug products, and manufacturer rebate contracts
• Ability to query data via SQL and other data analytic tools
• Excellent oral and written communication skills
• Strong leadership skills, with the ability to successfully train and develop staff
• Proven problem solving
• Ability to break down complex processes into simpler tasks and execute them
• Ability to establish and maintain collaborative relationships across functional units

Bachelor's Degree required

Business Overview
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.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.