Full Job Description
As an Enrollment Consultant, you will have the opportunity to maintain strong relationships with our Employer Group Waiver Plan (EGWP) and State Pharmaceutical Assistant Program (SPAP) clients. Your role will be essential for ensuring that all eligible beneficiaries are successfully enrolled in their respective Medicare Part-D plans and perform in accordance with Center for Medicare & Medicaid Services (CMS) guidelines. You will serve as the business expert for your clients in order to drive retention of the client base through successful results and supportive client consultation.
You will be responsible for owning and managing a book of business across multiple clients, resolving enrollment discrepancies, performing complex day-to-day enrollment tasks, understanding and applying Medicare Part D Guidelines, and managing small improvement projects. You will also have the opportunity to develop and maintain strong relationships with our clients and internal partners.
Roles and responsibilities of the Enrollment Consultant include, but are not limited to, the following:
- Lead and perform activities related to service delivery and resolution of client inquiries or issues.
- Consistently communicate project statuses to clients, lead weekly calls, and influence clients on implementing optimal enrollment practices.
- Monitor enrollment processes and analyze reports across multiple enrollment systems.
- Research, process, and formulate solutions for routine and complex enrollment issues.
- Identify potential process gaps and/or risks associated with client enrollment procedures, and contribute to finding innovative solutions.
- Review and resolve client and/or CMS enrollment audit inconsistencies and support internal departmental and external client calls independently along with capturing and delivering meeting agendas, minutes, action items, etc.
- Create and update client documentation, policies and procedures.
- Spearhead and/or contribute to small projects, including creation and execution of new processes or reports.
- Communicate professionally with internal partners and co-workers to drive success for the client and promote a collaborative work environment.
- Make sound business decisions based on instructions, policy and procedures.
- Deliver timely and accurate results with minimal supervision.
2+ years of prior intermediate experience using Microsoft Excel, and basic-to-intermediate experience using core Microsoft Office products, including Word and Outlook.
1 + years professional communication experience in verbal and written form.
Prior experience with RX Claim (AS400) and/or Salesforce
- Prior experience using VLookups and other query methods in Excel, and/or running SQL queries; MS Access database experience is a plus
- 1 + years of current experience with MS PowerPoint, Visio and Access
- 1 + years of business experience in client-facing relations or account management
- Prior Medicare Part-D, Employer Health Group and/or SPAP Plan related experience
- Strong interpersonal communication skills with ability to consultatively influence others
High School Diploma or GED Required
Bachelor Degree Strongly preferred
It’s a new day in health care.
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.
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