CVS Health Quality Assurance Analyst in Monroeville, Pennsylvania

Job Description

The Quality Assurance Analyst assures consistent quality of Specialty Services Revenue Cycle functions in order to yield improved financial results for CVS Specialty Health. The role will be accountable for conducting quality audits specific to Specialty Accounts Receivable and partnering with training and process improvement functions to enable continuous improvement. The role will also provide information to assist in the feedback and formal education process for specialty colleagues.

Utilizes defined quality assurance processes to conduct audits ensuring compliance with performance standards (e.g., quality, accuracy and timeliness)

Reports on performance results and may provide support to supervisors in the development of action plans for staff and unit effectiveness

Coaches Billing, Cash and/or Collections staff on work procedures to enable immediate improvements to financial outcomes

Provides on-going feedback and acts as subject matter expert in addressing procedural issues

Utilizes thematic outcomes of quality audits to identify individual and departmental training needs

Partners with training function to ensure training needs are addressed

Identifies developing trends impacting service levels and proactively partners with process improvement team to recommend process enhancements or solutions to avoid potential service delivery problems Ensures compliance with key regulations (e.g., SOX) and internal controls; serves as shared services center point of contact for internal and external audits

Partners with business leadership and business enablement functions to drive a culture of continuous improvement within the shared services center

Provides technical and subject matter expertise relative to policies, procedures, and A/R applications/systems tools

Contributes to team effort by accomplishing related results and other responsibilities as assigned

Required Qualifications

  • One or more years experience working in Healthcare Revenue Cycle

  • One or more years experience with Microsoft Office Suite, specifically Excel

Preferred Qualifications

Pharmacy or health care experience

  • Quality Assurance experience

  • Demonstrated analytical and problem-solving skills

  • Attention to detail and accuracy

  • Strong written and verbal communication skills

  • Strong organizational skills

Education

High School diploma/GED required; Bachelor's degree preferred

Business Overview

CVS Health, 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 Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf and EEO IS THE LAW SUPPLEMENT at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking Advice and Counsel at mailto:Advice&Counsel@cvshealth.com

CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.

For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/