Job Category: Account ManagementClinical Licensure Required : N/A Job Type: Full Time Position Summary: This is a client facing position which supports the management of: the relationship between CVS Caremark and the FEP Operations Center (FEPOC); day-to-day file exchanges between CVS Caremark, FEPDO, and FEPOC; supports the relations between our IT partners and the FEP account team; assists in monitoring the processing of claims between CVS Caremark and the FEPOC; performing extensive quality reviews of drug coverage, pricing, and plan design set-ups; and, assists in ensuring the RECAP system is properly set-up or updated with FEP specific details to support FEP claim adjudication. Each of these duties has a direct impact on meeting the measures and guarantees set forth in the FEP Retail, Mail, and Specialty contracts. Duties and Responsibilities:1- Coordinate with the Quality Advisor as the primary interface with the FEP Operations Center (FEPOC)2- Act as a business contact for CVS Caremark IT- which includes communicating and creating business requirements with IT for various FEP projects and testing to ensure projects were built according to design.3- Support the FEP Director’s Office (FEPDO) with FEPOC/CVS Caremark projects, issue resolution, and attend client meetings as needed4- Act as an internal resource, in support of various internal departments including: FEP Clinical Departments, HIPAA, Claims Processing, Plan Design, Audit, Customer Care, Enrollment, eBusiness, Account Team, and Finance.
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