Job Closed

This listing is no longer active.

Humana logo
Humana

Louisville, Kentucky-based Humana is a leading healthcare company that offers a variety of health, wellness, and insurance products and services designed to off

RN Care Manager - Janesville, WI

Location

United States

Posted

96 days ago

Salary

$71.1K - $97.8K / year

Seniority

Lead

No structured requirement data.

Job Description

RN Care Manager - Janesville, WI

Humana

Become a part of our caring community and help us put health first Enjoy a rewarding career with a true work/life balance—no nights or weekends, giving you more time for what matters most. Humana is currently seeking an RN Case Manager to join our team, serving members in the Wisconsin Family Care (FC) program. In this vital role, you will collaborate with dedicated colleagues to ensure exceptional care coordination for our members, providing crucial support and education to help them thrive in their daily lives. Take the next step in your nursing career and make a meaningful difference with Humana. Key Responsibilities: - Partner with a Care Coach (also referred to as a Case Manager), taking the lead on health-related needs, to collaborate on an ongoing basis regarding the member and their care plan - Conduct regular health assessments for members and implement appropriate strategies and services to develop individualized care plans that support their continued health and safety - Contribute to the creation, continuous evaluation, and coordination of the member's plan of care, including coordinating with outside providers to provide support with medication administration, assistance with home care, skilled nursing visits, and related services to ensure comprehensive care - Contact and coordinate with acute and primary care providers - Promote health and wellness through patient education on disease prevention, nutrition, exercise and lifestyle modifications - Provide members with education and information about disease processes and related risks, supporting informed decision-making while respecting each individual's autonomy - Daily documentation in member files within required DHS contract timeframes - Participate in member monthly phone contacts and attend in person visits in members setting - Traveling will be required and eligible for mileage reimbursement Use your skills to make an impact Required Qualifications - Associate degree in nursing - Must be a Registered Nurse, licensed in the state of Wisconsin in good standing Preferred Qualifications - Bachelors degree in nursing - Experience with Family Care target group: frail elders and adults with intellectual, developmental, or physical disabilities - Care Management experience Additional Information - Workstyle: This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes - Work Location: Janesville, WI and surrounding area. - Travel: up to 40% throughout Janesville, WI and surrounding area - Typical Work Days/Hours: Monday through Friday, 8:00 am – 4:30 pm CST WAH Internet Statement To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. - Satellite, cellular and microwave connection can be used only if approved by leadership. - Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Driving This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits. TB This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum. About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Related Categories

Related Job Pages

More Manager Jobs

Copart logo

CFR Office Supervisor - Florida region

Copart

Copart is a global leader in online car auctions, and a premier destination for the resale and remarketing of vehicles.

Manager96 days ago
OtherRemoteTeam 5,001-10,000Since 1982H1B Sponsor

Copart, Inc. a technology leader and the premier online vehicle auction platform globally, with over 200 facilities located across the world, Copart links vehicle sellers to more than 750,000 buyers in over 190 countries. We believe in providing an unmatched experience, every day and everywhere, driven by our people, processes, and technology. This role will report directly to the Inventory Management Manager and will be responsible for overseeing daily administrative operations, supporting our leadership team, and ensuring smooth coordination across the CFR function. The Global Call for Release Office Supervisor is responsible for leading a team of remote office staff to achieve customer service goals and ensure Copart processes are implemented and followed. The team that the remote OS oversees may have one or a variety of process areas they may be asked to support. Through a thorough understanding of Copart practices, the Office Supervisor will lead their team to facilitate a unique Copart experience for customers by implementing and maintaining Copart best practices that meet company policy, quality, and service expectations while working directly with any/all peer managers to successfully execute and propel the GCFR platform. Occasional travel as needed. Job Duties: - Hire, train, develop and motivate staff members. - Drive customer service by auditing call quality - Drive productivity and quality by auditing files via the system - Drive "1st call resolution" by reporting and auditing - Manage day to day needs of all position managed. - Ensure teams performance is within company standards. - Provide direction to team regarding all duties and goals. - Employee scheduling and attendance management. - Conduct employee performance reviews in a timely manner. - Give continual coaching to employees to foster transparent communication. - Ability to complete job task for position supervised. - Lead team to meet or exceed business goals. - Plan and lead virtual team meetings per company standards. - Handle employee/customer service issues - Other duties as assigned. Required Skills and Experience: - High School Degree (GED), some college preferred - Three (3) years office management or equivalent experience - Computer Proficiency (MS Office Suite) - Excellent communication skills -- verbal and written - Excellent customer service skills - Ability to hire, train and develop employees - Typing at least 45 Words Per Minute - Basic 10 Key proficiency - Ability to multitask in a fast-paced environment - Ability to manage expenses with basic accounting and inventory management skills - Ability to work in a fast-paced environment - Managing multiple processes for employees - Conflict management skills - Valid Driver's license - Ability to travel as needed - Ability to respond to alarm calls as needed - Bilingual skill a plus Pay $24.60 - $27.53 per hour Benefits Summary: - Medical/Dental/Vision - 401k plus a company match - ESPP - Employee Stock Purchase Plan - EAP - Employee Assistance Program - 10 Vacation days per year - 7 Paid Company Holidays - Life and AD&D Insurance Along with many other employee benefits. At Copart, we are focused on harnessing the power of diversity, inclusion, and collaboration. By embracing diverse perspectives, we open doors to innovation and unleash the full potential of our team. We are dedicated to fostering a workplace where everyone feels appreciated, included, and inspired to grow and contribute meaningfully. E-Verify Program Participant: Copart participates in the Department of Homeland Security U.S. Citizenship and Immigration Services' E-Verify program (For U.S. applicants and employees only). Please click below to learn more about the E-Verify program: - E-verify Participation - Right to Work

Florida
$25 - $28 / hour
Job Closed
Andersen Corporation logo

Regional Manager II

Andersen Corporation

At Andersen, we see possibility everywhere, every day and in everything we do. The possibility for our employees to achieve their full potential, for our communities to be stronger and for everyone to have a healthier, happier place to live. Join our more than 13,000 employees who are inspired every day to deliver exceptional experiences that turn possibility into reality.

Manager96 days ago
OtherRemoteTeam 5,001-10,000

ANDERSEN CORPORATION SUMMARY: At Andersen, we see possibility everywhere, every day and in everything we do. The possibility for our employees to achieve their full potential, for our communities to be stronger and for everyone to have a healthier, happier place to live. Our portfolio of brands — Andersen Windows & Doors, Renewal by Andersen and Fenetres MQ — is crafted to serve customers across the new residential, home improvement and light commercial building sector. Join our more than 13,000 employees who are inspired every day to deliver exceptional experiences that turn possibility into reality. JOB DESCRIPTION: Renewal by Andersen is seeking an experienced Senior Regional Manager II to provide strategic leadership and operational support across our North-Central and South-Central regions. This role is housed within our Cottage Grove, MN corporate headquarters, yet designed as a remote position, offering flexibility while maintaining strong alignment with our corporate team. You will serve as the primary relationship to independently owned and operated (ARO) retail management for an assigned group of accounts. Directly responsible for unit volume growth, market segment penetration and share, adherence to the RbA operating model, and legal compliance, Ensure Affiliates derive maximum value from RbA Cottage Grove (CG) internal services. Partner with ARO retail management to identify and anticipate support needs and consult on best practices for solutions. Prepare implementation plans and influence/support and assist in driving growth initiatives. Regularly evaluate lead flow, sales, operations, and installation performance. Work Cross-functionally with the internal Cottage Grove Resource teams to aid in increasing unit sales. POSITION RESPONSIBILITIES - Directly responsible for achieving window and door unit volume growth for the respective region and multiple key accounts. - Ensure annual unit volume targets and market segment share/growth targets are met by partnering with retail management to identify, motivate, direct, and oversee localized strategic initiatives. - Advise internal RbA Cottage Grove cross-functional teams on requirements needed to deliver corporate strategic initiatives such as new GM immersions, RBA Design Consultant Experience, Sales Excellence, Sales Methodology, Retail Council support. - Manage annual planning process with Affiliate retailers, in conjunction with data analytics to develop annual plans and ongoing business strategies to continue to drive retail unit volume growth. - Lead discussions, identify, drive to execution the areas of opportunity to drive market segment share. - Key activities include in person market visits to review execution of initiatives; Advise retailer on organizational design; talent reviews and warehousing/logistics opportunities and customer experience (NPS) requirements/compliance. - Enforce RbA legal contract compliance and RbA Brand Standard compliance. - Initiate, Develop and Foster strong relationships internally with the following teams: Marketing, RbA Technologies, Inside Sales Center, sales, operations, installation, service, and the Total Net Promotor Score (World Class Experience). - Collaborate with Cottage Grove department heads and teams to determine resources required to provide the support needed for each market to achieve goals. - Assess, advise, and consult as required to resolve Affiliate issues and conflicts. Key activities include conducting situational review, engage impacted/effected parties, drive to mutual resolution and build trust in the RbA model and products across affiliate regions. MINIMUM QUALIFICATION, SKILL AND/OR COMPETENCY REQUIREMENTS - Bachelor’s degree in business or related field or equivalent business experience. - Ability to analyze business and industry data. - Self-motivated and self-directed - 5-7 years of experience leading others, preferred. - Minimum of 10 years of experience in business operations, preferably in B to C industry. - Strong sales and influencing skills. Ability to work in a fast paced, entrepreneurial environment. - Exceptional customer relationship skills as well as leadership and change management skills. - Availability to travel up to 50% is required. - Strong business understanding and focus, with a proven drive to succeed. - Ability to handle multiple projects/priorities and adapt to new and changing situations. - Objective/factual approach to leadership, with an ability to influence and move people to decisions. PAY RANGE: $124,235.00 - $192,565.00 CULTURE AND BENEFITS: At Andersen, we believe our people are at the heart of everything we do. Every day, their talent, dedication and passion enables us to be the most trusted window & door company. To support our employees, we provide a comprehensive Total Rewards Package – a thoughtful combination of pay and benefits that reflects our commitment to investing in each team member’s wellbeing and success. While specific benefits may vary by position or location, we’re proud to offer a comprehensive Total Rewards Package designed to support your well‑being, growth, and future. Our benefits include: - 401 (k) Plan, Employer Fixed Contributions & Company Matching - Profit Sharing* - Medical, Dental and Vision Coverage* - Flexible Spending Accounts (FSAs)*, Health Savings Account (HSA) and Health Reimbursement Account (HRA) - Life Insurance - Paid Time Off & Paid Holidays - Paid Maternity Leave & Paid Parental Leave* - Career Growth Planning & Nationwide Career Opportunities *For employees covered by a collective bargaining agreement, some benefits may differ or may not be available based on the terms of the agreement. PROFIT SHARING: In 2026 Andersen has set a profit-sharing target of $3,600 per eligible employee, prorated as appropriate. Profit Sharing will be paid out in quarterly installments to provide eligible employees with payments throughout the year, with payment amounts tied to quarterly operating profit performance. EEOC EMPLOYER: Andersen is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, disability, marital status, national origin, citizenship, genetic information, protected veteran status, or any other characteristic protected by law. Andersen Corporation will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of all applicable federal, state and local laws. We look forward to seeing how your unique skills, background and experiences will inspire our team and help us continue to be the leader we are today.

United States
$124K - $192K / year
Cox Enterprises logo

Mobile Technician Leader

Cox Enterprises

For well over a century, Cox Enterprises has been shaping the future with daring ideas and values-driven thinking. Since our founding in 1898, our relentless spirit of innovation has driven us to disrupt industries and enhance the quality of life in the communities we serve. Through our major divisions — Cox Communications, Cox Automotive and Cox Farms — our people have countless opportunities to grow and make an impact in the communications and automotive industries, as well as in new ventures in agriculture, cleantech, digital media and more. As a privately-held, family-owned business, we know that people are our most valuable asset. We offer a supportive and inclusive environment with flexible career growth, amazing benefits and work-life balance at the forefront. Our mission, our ways of working and our commitment to people are what make our workplace culture remarkably flexible and resilient. Join us to build a better future and make your mark.

Manager96 days ago
OtherRemoteTeam 10,001+Since 1898H1B Sponsor

Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Manager, Truck Maintenance - Non-DOT Management Level Manager - People Leader Flexible Work Option Can work remotely but need to live in the specified city, state, or region Travel % Yes, 50% of the time Work Shift Day Compensation Compensation includes a base salary of $107,200.00 - $160,800.00. The base salary may vary within the anticipated base pay range based on factors such as the ultimate location of the position and the selected candidate’s knowledge, skills, and abilities. Position may be eligible for additional compensation that may include an incentive program. Job Description Cox Fleet keep your fleet moving. ****Equal Opportunity Employer, Disabled/Veterans encouraged to apply****  Cox Fleet is one of the largest fleet maintenance companies in the country! We are currently operating with 500+ mobile trucks and 20+ shops. As a leader and innovator in the mobile fleet service industry, we provide preventative maintenance excellence with proprietary technology tailored to each customer's unique needs. Our business has experienced substantial organic and acquisitive growth in the past few years, with additional significant future growth expected soon. As our business continues to expand, we are always on the lookout for motivated, energetic individuals to fill the positions now available on our talented team of professionals.   The Cox Fleet is currently hiring a Mobile Technician Leader to join our Management Team to support the future growth of the Company. If you are looking for a new place to call home, we would love to talk to you!   Duties: - Lead a team of 15+ technicians, provide leadership and guidance to deliver company results. - Meet one-on-one with direct reports to provide coaching and mentoring and help them find solutions. - Retrieve, review, and monitor metrics, reports, process documentation, customer service logs, and/or training or safety records as needed to analyze team productivity reports and follow up with technicians as necessary to make recommended changes to improve maintenance and repair efficiency. - Travel to technician and customer locations frequently. - Participate in and/or lead regular meetings with market team members across various organizational functions, such as dispatch, parts, and billing etc. - Monitor operations to ensure that technicians comply with administrative and DOT policies and procedures, safety rules and regulations, applicable environmental and/or government regulations, and work is accomplished in a manner consistent with organizational standards and requirements. - Perform onboarding activities for technicians, such as requesting equipment or tools and company-issued service trucks, completing all forms of new hire documentation, and/or providing access to various company systems to ensure all have resources, tools, and equipment they need to complete their work safely and effectively. - Regularly conduct safety audits and Quality Control Inspections (QCIs) and Safety Audits. - Assist in the development of and/or adherence to a monthly budget. - Coordinate with market team members to set goals and strategies for improving team and market productivity. - Collaborate and coordinate with dispatch and sales team to ensure each tech has a full schedule every day. - Delegate work to technicians as unscheduled repair calls come in and coordinate with internal team accordingly. - Participate in a regular safety meeting to review organizational safety information and messages to reiterate the safety culture of the company. - Implement safety processes and procedures and monitor technicians’ adherence to them. - Provide guidance and expert advice to management, subordinates, or customers on technical, systems- or process-related topics and encourage others to do the same. - Collaborate with customers to provide solutions that meet customer vehicle maintenance requirements. Able to function as liaison between FSCA technicians and customers. - Facilitate communication and problem solving across various organizational functions to resolve any issues. - Provide technicians with standard and emergency operating procedures for maintenance, replacement, and repair work. - Monitor inventory levels of equipment, parts, or tools across technicians. - Interview, select, and train new technicians. - Actively work across FSCA organizations to resolve items related to the technician’s role, such as HR, Parts/Procurement, Fleet Management, IT, etc. - Operate a company-issued vehicle to travel to technicians and customer locations. - May perform some technician duties such as preventive maintenance or parts repairs or replacements as needed using the appropriate tools and equipment to model appropriate practices for technicians. - Performs other duties and responsibilities as assigned.   Requirements - Bachelor’s degree in a related discipline and 6 years’ experience in a related field. The right candidate could also have a different combination, such as a master’s degree and 4 years’ experience; a Ph.D. and one (1) years’ experience in a related field; or 10 years’ experience in a related field. - 1+ year of experience in management or lead role. - Safe drivers needed; valid driver’s license required. - Due to interstate operating authority commerce regulations, candidates must be at least 21 years or older. - Skills in coaching, mentoring, teaching, discipline, having difficult conversations and ‘tough love’ as it pertains to mobile technicians. - Knowledge of the mobile work environment and challenges, maintenance practices, and processes requirements for mobile maintenance. - Ability to coordinate multiple group efforts to solve issues related to the technician job. - Ability to act with a high sense of urgency.   Required Competencies: - Ethics & Values: Adheres to an appropriate and effective set of core values and beliefs during both good and tough times; acts in line with those values; rewards the right values and disapproves of others; practices what he preaches. - Action Oriented: Has a sense of urgency daily; is action oriented; not fearful of acting with a minimum of planning; seizes more opportunities than others. - Technician Focus: Will seamlessly adjust leadership approaches and technique to manage a diverse set of technicians.  - Customer Focus:  Is dedicated to meeting the expectations and requirements of internal and external customers; gets first-hand customer information and uses it for improvements in services; acts with customers/technicians in mind; establishes and maintains effective relationships with customers/technicians and gains their trust and respect. - Systems: Demonstrated ability to learn and use IT systems related to technician day to day activity and performance, such as various dispatching software, reporting tools, Workday, Salesforce, Kronos, Power BI, etc. - Functional/Technical Skills: Has the functional and technical knowledge and skills to do the job at a high-level of accomplishment. - Listening: Practices attentive and active listening; has the patience to hear people out; can accurately restate the opinions of others even when he disagrees. - Interpersonal Savvy:  Relates well to all kinds of people – up, down, and sideways, inside and outside the organization; builds appropriate rapport; builds constructive and effective relationships; uses diplomacy and tact; can diffuse even high-tension situations comfortably. - Problem Solving:  Can identify problems and develop practical solutions. Able to understand internal constraints and avoid a ‘take it or leave it’ approach to problem-solving. WHY Cox Fleet? - Safety Boots & Safety Glasses reimbursement - Uniforms provided with laundry service where available - Technical training provided to advance your career - Dedicated career path – ‘Over 50% of our front-line managers are promoted from within’. BENEFITS - Health, dental, vision insurance starts DAY ONE of employment. - 401(k) matching starts after 90 days, 100% match up to 6% contribution and an additional 2% discretionary contribution by the company. - Accrue up to 200 hours (5-weeks) of Paid Time Off based on your tenure with the company. - Tuition Assistance/Reimbursement - Adoption/Surrogacy assistance - Pet Insurance - Multiple ERG, diversity groups, and company paid volunteer hours. - Employee discounts on new vehicle purchases, cellphone plans, ridesharing, home/rental insurance, wellness/fitness incentives and much more. - Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual’s age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship. Drug Testing To be employed in this role, you’ll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited. Benefits The Company offers eligible employees the flexibility to take as much vacation with pay as they deem consistent with their duties, the company’s needs, and its obligations; seven paid holidays throughout the calendar year; and up to 160 hours of paid wellness annually for their own wellness or that of family members. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells – or simply uses – cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer – All qualified applicants/employees will receive consideration for employment without regard to that individual’s age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship. Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.

United States
$107K - $160K / year
Job Closed
CVS Health logo

Manager, Pricing

CVS Health

CVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca

Manager96 days ago

• Leads with strategic leadership and guidance to pricing teams, ensuring effective response to pharmacy and state department of insurance (DOI) appeals are effectively reviewed and responded. • Partner with legal to disposition pharmacy complaints and appeals that come through state agencies • Leads and owns the process and work instruction documents that comply with state laws and meets CVS compliance • Leads and participate in state appeals audit and exam. • Provides the information to state DOI on the inquiries. • Interprets and drafts responses to state DOI inquiries and works with CVS legal team to respond to inquiries. • Collaborates cross-functionally with legal, compliance, network and other teams to manage the pricing appeals. • Influences stakeholders through effective communication and negotiation, leveraging pricing expertise and industry knowledge to establish mutually beneficial partnerships and agreements. • Networks with industry professionals through attending events and conferences related to company objectives, and participating in industry forums, monitoring emerging trends, and keeping updated on critical regulatory changes, ultimately improving innovation and maintaining industry leadership • Counsels and mentor pricing team members, providing guidance and support to enhance their pricing skills and professional development. • Delivers pricing solutions and recommendations that drive profitability and revenue optimization and contribute to the overall financial success of the organization.

Texas
$54.3K - $145.9K / year
Job Closed