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.

Position Summary:

For Medical: The PSL will serve as the Single Point Of Contact (SPOC) for the customer’s human resources personnel (benefit coordinator, administrator, etc.) and respond, manage, and resolve escalated and complex global issues for Claims/Calls and PSS.

Job Responsibilities:

• Acts as a single-point-of-contact for escalated member-specific issues and/or broader plan administration matters
• Develops and implements a customer service account management plan for each account.
• Support installation of new and existing accounts for the site by attending implementation planning/process meetings.
• Participate in prospect calls and help with response to RFPs.
• Customer visits (at their location).
• Proactively identify and surface customer and plan issues for resolution while acting as a liaison to communicate workflow results, ideas and solutions.
• Proactively resolve issues with account executives, sales representatives, installation managers and the claims office as appropriate.
• Manage escalated customer issues.
• Project lead for transition business in and out of service center.
• Attend and act as consultants for on-site audits.
• Assist customers and sales in understanding the impacts of non standard benefits.
• Coordinate/handle ad hoc account manager (AM) request allowing the AM the ability to focus on developing strategies for new and existing business opportunities.
• Proactively analyzes constituent data, identifies trends and issues.
• Identifies most urgent business problems, obtains necessary information, accurately identifies root causes and generates solutions.
• Initiates and maintains partnerships with others throughout the organization.
• Encourages cooperation by promoting common goals and building trust. Inspires, supports, and initiates cross functional activities.

Required Qualifications:

• Must be within one of the following Time Zones; EST or CST.
• Will be supporting high touch plan sponsors in the northeast.
• 2+ year Member Services, Quality Assurance OR Claims Processing
• Demonstrates strong consultative skills and the ability to Influence constituents.
• Strong leadership skills.
• Strong communication skills (verbal, written, presentation).
• Strong understanding of multiple aspects of the plans and products (e.g., CCI coding).
• Ability to work with cross-functional business units and vendors to support the customer’s needs; promotes collaboration among constituents and represents a professional image of the company.
• Strong project management skills.
• Ability to support multiple plan sponsors and multiple products.
• Critical thinking and decision making skills
• Auto-adjudication knowledge (e.g., number of claims affected on on-standard plans, knowing when a benefit auto adjudicates).
• Strong knowledge of Aetna Standards.
• The candidate must have a strong track record of success in customer service leadership while exhibiting excellent oral and written communication skills.
• The ideal candidate must have strong business and organizational knowledge and be well organized.
• This position requires the demonstrated ability to influence others and win support on critical issues and often requires problem solving skills and the ability to manage multiple priorities, tasks & fluctuation deadlines.

Preferred Qualifications

• ACAS and/or Rumba experience

Education:
High school diploma plus work experience

Pay Range

The typical pay range for this role is:

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.

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, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits