Manager, PBM Invoice Processing

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

Manages day-to-day activities of team by providing strategic leadership and overseeing the operations of the Invoice Processing Team within Meritain Health's PBM Operations department. Directs workflow to ensure the efficient and accurate processing of PBM invoices and claims by establishing and monitoring productivity and quality metrics, managing and developing a team of claims support individuals, implementing process improvement initiatives, and fostering collaboration with internal and external stakeholders to optimize claim processing, minimize errors, and enhance overall operational effectiveness and customer satisfaction.

Job Duties

Review and address any complex or escalated issues to provide guidance to invoice processors in handling challenging cases.

Designs quality control processes to ensure the accuracy and consistency of invoice processing, including critical follow-up procedures for effective final resolution.

Analyzes invoice processing data and generates reports to track and evaluate key performance metrics, such as claim volume, turnaround time, accuracy rates, and productivity.

Collaborates with other departments, such as Client Management, File Management, and Stop Loss to ensure effective communication and coordination in the invoice processing workflow.

Encourages feedback from invoice processors, gathers suggestions for process enhancements, and implements changes that improve efficiency, accuracy, and customer satisfaction.

Ensures compliance with industry regulations, company policies, and legal requirements related to invoice processing and implements necessary adjustments to processes, documentation, or reporting requirements to maintain compliance.

Oversees ongoing training to ensure all team members are fully versed and compliant within their respective roles for invoice and claims handling and escalation.

Coordinates with internal and external business partners to provide leadership, functional advice, and training to staff as needed.

Required Qualifications

• 2+ years management/leadership experience.
• Proven strong leadership skills managing large high-performance teams, setting strategic direction and influencing change that resulted in quantifiable positive outcomes.
• 2+ years Healthcare industry experience required.
• Adept at problem solving and decision-making skills.
• Adept at collaboration and teamwork.
• Adept at growth mindset (agility and developing yourself and others) skills.

Preferred Qualifications

• Pharmacy Benefit Management (PBM) Operations experience.

Education
Bachelor's degree or equivalent experience.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$54,300.00 - $159,120.00

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. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• 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.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 06/30/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.