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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

As a Manager, Resource Planning, for CVS Health you will be accountable for the execution in achieving operational excellence and compliance for Clinical Government Services Operations (CGSO), to include, but not limited to:

• Commercial & Exchange PA & Appeals Operations.
• Case Review Unit - Specialty Guideline Management PA & Appeals Operations.
• Caremark Medical and Aetna Medical.
• Medicaid PA & Appeals Operations.
• Medicaid and Medicare Data Entry Operations for partially delegated clients.
• Pharmacy Advisor (RxADV).
• Medication Therapy Counseling (MTC).
• Government Services Operations, Coverage Determinations and Appeals.

• Partner with Finance and Forecasting teams frequently to develop and adhere to an annual business expense budget.
• Provide leadership and guidance for colleagues dedicated to ensuring CGSO call center and employee productivity metrics are met. Help foster a growth mindset and build a strong team that is agile in a fast-pace environment. This position will manage through subordinate leaders including Supervisor level to execute organization and business objectives.
• Oversee team management of approximately 2000+ Clinical internal/contingent workforce colleagues comprised of mainly Coordinators, Technicians, Clinicians, and Pharmacists across different sites and WFH for unique line of businesses.
• Plan operational resources that require close and frequent collaboration with Clinical operational leaders, enterprise business partners, Telecom Voice, Call Delivery Solutions, Call Recording Solutions, system Vendors, Verint Support Group, and other Workforce. Management teams to drive success and ensure call delivery, call recordings, toll free routing of phone and fax lines are in support of current programs, labor expense initiatives, and future strategies.
• Ensure compliance with all appropriate regulations - Federal and State, accreditation standards - URAC and NCQA, client requirements, and performance guarantees. Ensure compliance with rigorous government standards required by both the Center for Medicare & Medicaid Services (CMS) and Affordable Care Act (ACA).
• Oversee of all Resource Planning activities- Timekeeping and Attendance, Workflow Management, Reporting and System Maintenance related to Clinical Government Services Operations (CGSO).
• Work in collaboration with Time and Attendance staff members in partnership with CVS business team members and external work teams to ensure employee timekeeping and attendance records are accurate and appropriately reviewed in accordance with the Time and Attendance guidelines and required processes.
• Ensure consistent processes and adopt best practices across diverse and complex CGSO lines of business which are made up of varying regulatory and client commitments. Drive productivity and quality improvements through process streamlining and automation year over year to achieve best in class service and lowest cost to serve.
• Manage labor budget while driving process improvement and productivity strategies to deliver the lowest cost serve rate in the industry. Our labor strategy is executed across 6 different locations and WFH while leveraging a combination of internal and contingent colleagues. The labor plan includes management and execution of new client implementations along with new volume ramp to enable successful delivery of the programs. This includes new colleagues being on-boarded, trained and certified to handle volume associated with the seasonality of the program and product execution.
• Partner and collaborate effectively with Ops Technology and Operations to identify and capture issues/risks and ensure appropriate engagement to drive decisions and deliver on commitments. Lead the delivery of workflow solutions including inbound and outbound call routing, and system infrastructure support for WFH and in office colleagues.
• Have a comprehensive understanding of Clinical business strategy in combination with workforce management industry knowledge to achieve Clinical organizational goals, including supporting savings initiatives, performance efficiencies, and ensuring staffing plans align to overall budget.
• Provide guidance on performance improvement opportunities and works cross-functionally to create actionable goals to be implemented accordingly for expected/anticipated results. Champion of the Productivity Analytics team in resolving complex inefficiency challenges.
• Engage actively on employee recognition, coaching and development, and engagement.
• This role supports and develops a team of Leaders that have a passion for Workforce Management. Working to ensure that all members of the team deliver results related to Clinical goals while focusing on CVS company values and behaviors.

• 3+ years of leadership experience in a highly functioning call center environment.
• Experience in Workforce Management systems including, but not limited to: Verint I360, Five 9, Mattersight, Avaya CMS, Avaya Proactive Dialer, NICE inContact Dialer, Moxie, Microsoft Office and Tableau.

• Knowledge of CAS, MHK, Novologix, People Safe, Compass.

• Bachelor's Degree required; equivalent experience may be considered.