Implementation Specialist; Meritain Health

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.

The Implementation Specialist manages and coordinates benefit plan implementation for new and existing customers. This person provides focused service, fostering strong relationships with internal business partners, in order to assure all group implementation and administrative updates are loaded correctly.

• Analyzing and determining if products and services selected by clients are aligned and can be adequately supported by existing systems or operating platforms; additionally, seeking solutions and negotiating essential requirements in support of any non-standard plan selections. Requires dynamic decision making to appropriately structure the group setups within the Meritain system to align with our vendor partners (Pharmacy Benefit Managers, Managed Care Entities, etc.)
  
  and analytics vendors, and provide the required structure for client billing and reporting.
• Actively consulting and communicating with internal staff regarding the details associated with new business and revision activity in a timely manner, as well as validating account structure.
• Completing timely and accurate set-up of complex account structure and detailed benefit plans in systems (for multiple constituents), in order to satisfy both internal and external deadlines for production, impacting a wide variety of products and services.
• Monitoring and managing internal installation process, as well as maintaining case tracking to meet constituents’ expectations and business goals.
• Maintaining data files for monthly group reporting, assuring PHI (Personal Health Information) guidelines are being followed.
• Running monthly reports for all clients and brokers.
• Responding to escalated issues related to group setup.
• Assisting with the development and testing of new or enhanced group setups.
• Providing technical expertise to team/unit, mentoring junior staff members, and assisting with the development and implementation of training tools and processes.
• Running adhoc data programs to assist with streamlining setup of group and eligibility files.
• Running adhoc data programs to quickly audit setup of customized group enrollments.
• Partnering in projects with our Products and IT teams to add/enhance products and services.
• Serving as the point person for testing of all changes related to the ER/EO/GIM data files.
• Performing other duties as needed.

• 1+ year of experience in health care.

• 3+ years of experience in health care.
• Previous experience in medical group implementation.
• Previous experience working with medical data files.
• Detail-oriented.
• Strong analytical skills.
• Excellent multi-tasking ability.
• Associate’s degree or higher.

• High school diploma or GED.

40

Full time

The typical pay range for this role is:

$46,988.00 - $

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our…