As a Quality Assurance Advisor you will incorporate experience as an operations manager with pharmaceutical oversight in claims adjudication, reporting, fee schedules, contracting, clinical effectiveness, utilization management, and rebate reconciliation; a firm understanding of federal and state regulatory compliance; and a general understanding of the I.T. operations required for successful outcome measures for performance related testing and audits.
Required Experience in PBM testing
Required Experience in Clinical and Utilization management
Required Bachelor Degree or Expert level experience (8 yrs)
Pref Pharmacy Technician Certification
Pref Experience as Payer Operations Management
Pref Experience in Pharmacy Audits
Pref Other Certificates or Licenses (List)
Bachelor Degree in Pharmacy
CVS Caremark, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day.
As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units - MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.
medITjobs.com - 18 months ago