Senior Manager, Product Implementation

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.

Senior Manager of Product Implementation

Position Summary

The Product Implementation Manager position is responsible for the implementation and the point of contact for benefit inquiries for Individual Medicare health products for downstream partners. There is an additional focus on quality assurance to confirm, from end-to-end, that what the product implements is supported by our product filings.

Support  and assist the annual Medicare bid filing processes.

• Participate and research new benefit ideas presented for consideration during the annual Operational Feasibility process.
• Ensure accuracy of benefit data in the annual bid submission, member materials, sales/marketing materials, customer service databases, and internal/external websites.

Implement Annual Medicare benefits

• Use project management skills and methodology to annually implement Medicare benefits
• Create and secure approval of the annual project plan that incorporates feedback and other area’s timelines to implement the annual Medicare implementation.
• Create SOT Requirements that incudes benefit intent, operational approaches, administrative nuances for each new benefit and is updated as changes to benefits are approved.
• Coordinate SOT Requirement approval with Product Owners prior to implementation and prior to the New Benefits moving to the NextGen Production environment.
• Write, edit/review training documents for testing, implementation tools, administrative policies pertaining to new benefits, project plans and requirement documents.
• Coordinate and support the claim testing process and assist in the review and approval of testing outcomes.
• Coordinate and maintain the annual RASI document that supports implementation.
• Report progress and readiness for the AEP and the 1/1 effective date.

Additional Responsibilities

• Create and release project reporting using metrics and validation to confirm implemented benefits are delivering the benefit intent.
• Develop product recommendations based on findings of the reporting and validation programs.
• Joint administrative ownership of the Implementation Team’s project QuickBase and SharePoint sites.
• Research and respond to administrative questions for benefit; inquiries and escalations.
• Review and approval of NextGen Product and Benefit Team’s Business Requirement Document (BRD)
• Review and consult on Service Now claim production issues (SNOW Tickets)

Required Qualifications:

• 4+ years related cross-functional, project management experience including product implementation
• 4+ years Medicare Advantage in any area such as product, claims, clinical, operations, implementation
• Understanding the six sigma methodology

Preferred Qualifications:

• Intermediate knowledge of company’s core functions i.e., claim progressing, provider billing,
• benefit configuration, ID Cards, provider set up, etc.
• Prefer Six Sigma Certification i.e., Lean or Green Belt

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.  This position also includes an award target in the company’s equity award program. 
 

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.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

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

For more information, visit https://jobs.cvshealth.com/us/en/benefits

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.