Bus Project Program Mgr
Posted on: 19 Feb 2021
Louisville, KY
Job Description
Job Description
The Business Project Program manager will interface with operations shared services partners to ensure compliance with regulatory metrics. This role will also support the chief operating officer in overseeing day to day operations of health plan, working with stakeholders, and executing on strategic measures.
Required Qualifications
5+ years of Medicaid experience. Strong analytical skills and attention to detail, including interpreting and executing regulatory and contractual language. Understanding of health plan operations, including contracting, claims processing, encounter data processing, and Medicaid eligibility and enrollment. Experience navigating a matrixed organization.
Preferred Qualifications
Experience developing and executing project plans and processes. Compliance or other regulatory experience. Understanding of legislative, administrative, and regulatory processes in Kentucky. Experience with relevant stakeholders including the Kentucky Department for Medicaid Services and Kentucky medical provider community.
Education
Bachelors degree required.
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
CVS Health
Woonsocket, RI
CVS Health Corporation provides health services and plans in the United States. Its Pharmacy Services segment offers pharmacy benefit management solutions, such as plan design and administration, formulary management, retail pharmacy network management, mail order pharmacy, specialty pharmacy and infusion, Medicare Part D, clinical, disease management, and medical spend management services. The company’s Retail/LTC segment sells prescription drugs and general merchandise, such as over-the-counter drugs, beauty products, cosmetics, and personal care products, as well as provides health care services through its MinuteClinic walk-in medical clinics.
Its Health Care Benefits segment offers traditional, voluntary, and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, medical management, Medicare plans, PDPs, Medicaid health care management services, workers’ compensation administrative services, and health information technology products and services. The company’s customers include employers, insurance companies, unions, government employee groups, health plans, Medicare Part D prescription drug plans, Medicaid managed care plans, plans offered on public health insurance exchanges and private health insurance exchanges, other sponsors of health benefit plans, individuals, college students, workers, labor groups, and expatriates.
As of December 31, 2018, it had approximately 40 leased on-site pharmacies, 25 leased retail specialty pharmacy stores, 20 specialty mail order pharmacies, and 90 branches for infusion and enteral services; and 9,900 retail locations and 1,100 MinuteClinic locations, as well as operated an online retail pharmacy Websites, LTC pharmacies, and onsite pharmacies. The company was formerly known as CVS Caremark Corporation and changed its name to CVS Health Corporation in September 2014. CVS Health Corporation was founded in 1963 and is headquartered in Woonsocket, Rhode Island.
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IndustryHealthcare
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No. of Employees295, 000
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Website
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Jobs Posted4287
