Senior Manager - Contract Manager and Member Advocate

5 days ago

🐊 Florida – Remote

Although this job is listed in Florida, this company may be open to hiring remote in other states.

💵 $67.9k - $149.3k / year

⏰ Full Time

🟠 Senior

👔 Manager

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CVS Health

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CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

Retail • Pharmacy Benefits Management • Health Insurance • Health Care • Pharmacy

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

📋 Description

• Oversees all aspects of ABH-FL’s performance in fulfilling the FHK contract requirements. • Communicates and interfaces with our FHK client and regulator, at the coordinated direction of Director of Contract Management. • Advocates for these members until benefits or other issues are resolved. • Is highly responsive to the regulator’s requests. • Keeps ABH-FL leaders promptly notified of FHK personnel changes, policy changes, and other relevant client changes. • Establishes a positive rapport with client; demonstrates helpfulness and partnership to achieve client’s goals. • Demonstrates adequate knowledge of the Medicaid contract within 4 months. • Provides FHK contract expertise to Plan colleagues and guides their FHK submissions. • Exercises Quality Control on all communications and regulatory reports delivered to regulators. • Ensures accurate and timely responses to all regulatory queries and maintains records of all these communications. • Attends, participates, and assists as needed: Compliance and Policy related Committee activities.

🎯 Requirements

• 3+ years professional experience in health care benefits or a Medicaid-related program position. • Requires competency in MS Office applications, including Excel and PowerPoint, as well as demonstrable basic experience in project management. • Interpersonal and relational skills; patience and a customer-first disposition. • Must be a state of Florida resident. • A successful background check with fingerprints.

🏖️ Benefits

• Affordable medical plan options, • 401(k) plan (including matching company contributions), • 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.