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Team Lead - Adjustment and Recovery
Team Lead - Adjustment and Recovery-February 2024
Michigan
Feb 6, 2025
ABOUT CVS HEALTH
CVS Health is a healthcare innovation company. Together, we are helping people on their path to better health.
10,000+ employees
Healthcare
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About Team Lead - Adjustment and Recovery

  Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

  Position Summary :

  Responsible for researching complex tasks and solutioning encountered system issues; maintaining and managing automating adjustment programs/processes; providing support to leadership to meet business KPI’s; conducting user acceptance testing (UAT). Perform associated team lead duties to maintain and meet business performances. Manage work inventory; provide training on work tasks; mentor and be the subject matter expert (SME) to team members.• Support leadership, assist in strategic planning and overall work completion to meet established KPI’s.• Collaboratively develop training materials; perform training to new hires or internal cross-trainings.• Facilitate meetings to staff and/or other departments; provide updates/clarifications for accurate completion of work tasks.• Mentor and provide guidance on adjustments, posting of refunds, and/or recovery to team members; review and direct resources to ensure accuracy.• Distribute urgent/escalated work assignments daily to staff.• Use analytical and statistical techniques and tools to plan and perform research and analysis of processes (e.g., outcomes performance guarantees, government regulations, and customer requirements, etc.) to recommend enhancements and workable solutions.• In partnership with business owners, support the design and development of new processes.• Participate in the development and validation of master or detail UAT test plans and strategies.• Develop and design data collection capability (e.g., recovery, work inventory)• Lead working sessions to develop processes and/or resolve issues, including create enhancements and process efficiency.• Support the creation of communication strategies and presentations for both internal and external customers to educate and address continuous improvement initiatives.• Analyze and resolve complex adjustment scenarios within established time frames.• May, under supervision, develop quality assessment/measurement programs tailored to specific assignments.• Analyze customer feedback and other measures.

  Required Qualifications :

  • 2+ years claim adjustments experience.• Excellent verbal and written communication skills.• Independent decision-making skill.• Effective organizational and interpersonal skills.• Demonstrated ability to handle multiple assignments competently, accurately, and efficiently.

  • DG system claims processing experience.

  Preferred Qualifications :

  • Experience working on project teams• Experience conducting user acceptance testing (UAT)

  Education :

  Associate degree or equivalent experience.

  Pay Range

  The typical pay range for this role is:

  $19.52 - $36.78

  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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

  CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

  You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

  CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.

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