Supervisor, Specialty Revenue Cycle Quality Assurance Monroeville, PA (Hybrid)

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary
CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area has an opportunity for a full-time Supervisor, Specialty Revenue Cycle Quality Assurance. Under direction of the Training and Quality Assurance Manager, this role assures consistent quality of Specialty Revenue Cycle functions to yield improved financial results for the Specialty line of business. The incumbent will be accountable for leading a team of auditors who, utilizing defined quality assurance processes, conduct work audits ensuring compliance with performance standards (e.g., quality, accuracy and timeliness) and partnering with training, analytics and process improvement functions to enable continuous improvement and elevate the entire quality assurance program. The Supervisor will also provide information to assist in the feedback and formal education process for Specialty colleagues. As part of this team, you will work in a fast paced and team focused environment.We will support you by offering all the tools and resources you need to be successful in a collaborative team environment.Located in the Monroeville facility, this opportunity also provides free parking.Key Responsibilities of the Supervisor, Specialty Revenue Cycle Quality Assurance:

• Oversees day-to-day operations of the team to ensure timely and accurate completion of all Quality Assurance (QA) activities, including completion of assessments and dispute resolutions; provides on-going feedback, Revenue Cycle process training, and acts as subject matter expert in addressing QA processes and procedures.
• Collaborates with QA Sr. Analyst to initiate, develop, test, and implement workflow and process efficiencies that help the department continue to automate and standardize output.
• Maintains the active QA roster of QA-eligible colleagues, including adding new hires, removing terminated colleagues, updating leaves of absence and other status changes.
• Plans and adjusts weekly and monthly production volumes and work scheduling to meet business expectations.
• Initiates and manages projects such as guidelines revisions and new department onboarding utilizing Revenue Cycle operations experience; sets and leads project meetings and provides meeting minutes and task assignments afterwards.
• Coordinates and collaborates with Revenue Cycle leadership to create effective collaboration and integration of QA Colleagues and business partners
• Reports on performance results, disputes and resolutions, and other critical metrics to leaders; analyzes and uncovers trends in quality audits to identify individual and departmental challenges and partners with leadership and training team to foster continuous improvement and develop remediation activities.
• Creates a work environment for employees through team building, coaching, constructive feedback, work delegation, personal example and goal setting that encourages creativity, open dialogue on work issues, professional growth, and a consistent, high level of performance; encourages and supports employee decision-making within his or her scope of responsibilities
• Completes regular individual check-in meetings; conducts formal and informal performance reviews for employees and provides timely feedback, coaching, and performance improvement plans as needed.
• Attends and participates in monthly Revenue Cycle Supervisor meetings; contributes QA updates as appropriate; presents Quality Assurance department overview to new leaders.

• 2+ years of experience in a Supervisory or leadership role.
• 1-2 years of Specialty Pharmacy Revenue Cycle Billing and Collections experience (Accounts Receivable, Accounts Payable, etc.)
• MS Excel Skills: basic formulas, charts and pivot tables, filters, and editing spreadsheets.
• Must live within a 2-hour commute to the Monroeville, PA.

• 3+ years Revenue Cycle Management experience; 1-2 years' experience with medical benefits and 1-2 years' experience with pharmacy benefits.
• Demonstrated proficiency from prior quality assurance programs.
• Advanced Excel experience, including complex formulas, charts and pivot tables, conditional formatting, and data validation functions.
• Experience using the Microsoft Office Suite, specifically Excel, Teams, PowerPoint, Outlook and Word.
• Experience working with medical/pharmacy billing and reimbursement practices.
• Demonstrated analytical and problem-solving skills.
• Ability to effectively manage people and provide team leadership and engagement.
• Ability to evaluate work and process flow to ensure optimal efficiencies.
• Attention to detail and accuracy.
• Experience with Quality Assurance practices.
• Bachelor's Degree preferred.

• High School Diploma or related work experience.

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.