Manager, Member Billing

at  CVS Health

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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.

POSITION SUMMARY

The Manager, Member Billing is a member of the Pharmacy Benefit Management (PBM) Finance Operations Department. The Manager will play a critical role in building the processes and infrastructure to establish a new department supporting invoicing and accounts receivable management for Medicare Part D members utilizing the Medicare Prescription Payment Program (M3P). The Manager will oversee team of colleagues responsible for one or several functional units within the Copay Billing team including: Invoicing, Dunning, Reinstatements, Balancing/Reconciliations/Out-of-Balance Research, Disputes, and Cash Application.
M3P is a Medicare Part D requirement effective January 1, 2025, and thus, the Manager will partner with teams from across the PBM organization as well as third parties to ensure thorough establishment of systems, processes, and business practices needed to effectively manage the financial aspect for M3P enrollees. The Manager will partner with other leaders to understand regulatory requirements, document business requirements for IT and vendor partners, and help to determine the structure and best practices for the new Med D Member Copay Billing organization. You will play a critical leadership role during implementation and within the team post go-live.
This is a hybrid role and will require 3 days per week onsite at one of our PBM locations. Other CVS Health locations may be considered.

REQUIRED QUALIFICATIONS

• 5 or more years of experience in healthcare finance, billing, or a related field, with an emphasis on accounts receivable, billing, payment application, or reconciliation
• 3 or more years of direct people leadership experience

PREFERRED QUALIFICATIONS

• General PBM experience and knowledge
• General knowledge of Medicare Part D
• Ability to follow, interpret, and comply with CMS and other regulatory requirements
• Knowledge of SAP, S4, Salesforce, RxClaim, PeopleSafe, Compass, Facets, and other Caremark specific applications
• Experience writing user stories, requirements, and tasks in support of IT projects
• Strong relationship building and communication skills
• 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

EDUCATION

• Bachelor’s Degree or equivalent experience required
  This is a hybrid role located at any one of our corporate CVS locations

Please refer the Job description for details