Process Manager

Job not on LinkedIn

🔥 0 minutes ago

🤠 Texas – Remote

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💵 $60.3k - $132.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚙️ Operations

👻 Ghost score 0%

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Logo of CVS Health

CVS Health

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Lead cross-functional initiatives involving new ePA processes, workflow enhancements, vendor onboarding, system integrations, automation capabilities, and operational improvements • Meet with business leaders and stakeholders to evaluate ePA and interoperability processes and identify opportunities to improve efficiency, scalability, and effectiveness • Build and manage relationships with ePA external vendors, network partners, and solution providers • Identify business risks, operational challenges, and ePA improvement opportunities, and execute action plans • Establish regular stakeholder meetings, operational reviews, and business updates • Identify opportunities for innovation, automation, and process optimization • Assess business and customer needs and recommend new capabilities, process enhancements, digital solutions, and emerging technologies • Monitor vendor performance, implementation progress, operational metrics, business outcomes, and value realization objectives • Support business case development, vendor evaluations, contract reviews, and operational planning • Establish success metrics, measure return on investment, and track value realization • Analyze operational performance, transaction trends, financial and operational impacts, and process outcomes • Evaluate emerging technologies, AI-enabled capabilities, and workflow optimization opportunities to improve provider, client, and member experiences

🎯 Requirements

• 5-7 years of experience in healthcare operations, business process management, clinical operations, healthcare technology, healthcare interoperability, or a related field • Adept at problem solving and decision making skills • Adept at collaboration and teamwork • Adept at growth mindset (agility and developing yourself and others) skills • Adept at execution and delivery (planning, delivering, and supporting) skills • Experience leading cross functional initiatives involving business, technology, operations, and external vendors • Strong communication, stakeholder management, and relationship building skills • Experience with electronic Prior Authorization (ePA), Prior Authorization operations, Utilization Management, Pharmacy Benefit Management (PBM), or healthcare interoperability • Experience managing relationships with healthcare technology vendors, ePA network partners, or interoperability solution providers • Knowledge of NCPDP SCRIPT standards, CMS interoperability requirements, FHIR APIs, and related healthcare data exchange standards • Experience leading vendor onboarding, enterprise implementations, integrations, and operational transformation initiatives • Project management experience supporting complex cross-functional programs and strategic initiatives • Bachelor's degree preferred • 8-10 years of relevant experience in healthcare operations, clinical operations, vendor management, business process management, or related disciplines • Bachelor's degree preferred or equivalent combination of specialized training, professional certification, and relevant work experience

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program in addition to base pay

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