Medicare D Enrollment Consultant - Full-time / Part-time

Job Category: Business Analyst

Clinical Licensure Required : N/A

Job Type: Full Time Position Summary:

The Enrollment Consultant will serve as the primary contact supporting Employer Groups Waiver Plan (EGWP) clients Medicare Part D enrollment needs for CVS/Caremark. The Enrollment Consultant is the subject matter expert for Medicare guidelines, EDI Protocol, File Layouts having full knowledge of processes and impacts. The Enrolment Consultant are fully accountable for client education that drives required actions by the client, minimizes rejections to achieve successful enrollment outcomes. The Enrollment Consult owns responsibility for timely and accurate end to end processing for enrollment (Batch, Portal, Paper, etc). The Enrollment Consultant will lead implementations for new and/or existing clients, utilizing standard implementation tracking and documentation tools. The Enrollment Consultant will be responsible for performing medium to complex data analysis utilizing intermediate or advance Microsoft excel and access tools to identify and resolve enrollment related issues. The Enrollment Consultant is expected to complete required training courses and utilize resources available to exceed client expectations, which includes self-paced learning. The Enrollment Consultant will work closely with their Clients and internal partners (primarily account management) to ensure the timely, accurate, and compliant enrollment, maintenance, and disenrollment of the client's beneficiaries.

Note: The Enrollment Consultant will be required to provide after hour client support and the Saturday rotation schedule.

Enrollment Consultants responsibilities will include (not limited to):

* Heavy proactive client interaction -- 80%

* Managing multiple clients (count vary by complexity)

* Facilitation and documentation of client meetings (Conference Calls and/or Onsite meetings)

* Enrollment process monitoring across multiple systems/processes

* Analyze reports and communication results to client (FBF/SLRs, etc)

* Enrollment Reconciliations

* Implementations - min 20%

* Proactive escalation of potential issues

* Development and on-time execution of client action plans

* Support or lead file mapping efforts

* Create and/or update client documentation and/or P&Ps

* Ability to travel up to 10%

* Special Projects

Required Qualifications:

*3+ years SFTP, Electronic Data Interchange (EDI) formats and file transfer protocols.

* 5+ Years in Healthcare, PBM or insurance

* 5+ Years Business to Business client relations preferably in Account Management and/or Implementations

*5+ Years - Intermediate to advance level experience with MS Excel, Access, Outlook and Powerpoint

* Effective presentation skills over the phone and in person

* Ability to interpret and present complex concepts that are easily understood by others

*Analytical thinking, strong Interpersonal skills, and strong Technical aptitude.

Preferred Qualifications:

*A Bachelor Degree, pass experience

*CMS guidance Demonstrated strong written and verbal communication skills

* Analytical thinking, strong Interpersonal skills, and strong Technical aptitude. Prior use of RxCLAIM, Quantum Leap, MEDS, preferred Access. Experience with Visio, Project and Facets also a plus. Education:

Bachelor Degree or equivalent work experience Business Overview:

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.

CVS Caremark is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, color, gender, national origin, ancestry, religion, physical or mental disability, age, veteran status, sexual orientation, gender identity or expression, marital status, pregnancy, citizenship, or any other factor protected by anti-discrimination laws. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW

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