Manager, Claim Processing

Step Up to Caremark

Are you looking for a stable, yet dynamic company you can grow with? Caremark is a Fortune 100 company, dedicated to improving the lives of millions of Americans. As one of the largest Prescription Benefit Managers (PBMs) in the United States, we provide health management solutions to corporations, insurance companies, unions, government agencies, and managed care organizations. With the recent integration of Caremark and AdvancePCS, an industry leader with a bright future has emerged.

Continuing market share growth and product diversification guarantee a dynamic work environment with real career path opportunities. If you would like to join a company that empowers you to succeed, look to Caremark for the next best step in your career.


Title: Manager, Claim Processing


Position Summary: Manage the Claim Department processes and staff which is composed of supervisors and claims processors in support of Caremark's member and government agency submitted paper claims operations. Responsible for the quality and timeliness of claims payment in accordance with client service level agreements and company standard operating procedures, and state and federal regulations. Manages the adjudication responsibilities for commercial and government claims. Responsible for the initiation and follow through of change to ensure best practices are implemented across processing platforms.

Position Requirements: Bachelor Degree in Business or Healthcare Management. 5 years management experience in a pharmacy or medical claims adjudication environment. Knowledge of claim adjudication principles and government regulations in regards to claims processing; understanding of budgeting and human resource policies and procedures; ability to run a high volume production oriented department with an emphasis on quality output in excess of 99% accuracy; excellent verbal and written communication skills; ability to interface with internal and external business partners and clients in a professional manner; ability to make sound operational decisions in a fast paced, high stress environment; ability to effectively manage multiple tasks and projects; good command of Microsoft Office applications, i.e. Word, Excel, Powerpoint.


If you meet the qualifications for the following position, please apply to www.caremark.com.

• Click on “Careers at Caremark” located under “About Caremark” in the right side column of the Caremark.com home page. Apply under Manager, Claim Processing (8595BR) within Scottsdale jobs.
• The Careers Navigation page follows where you can search for open positions, view a video of specific job environments, review a listing of our locations, etc.
• By clicking on the ”Search Jobs” link you will have the ability to search for open positions, create a profile, load your resume, and submit it to open positions.
• If you are returning user you can login to change your profile, apply to any new positions, and upload new resumes.

Caremark Benefits:
Caremark offers a competitive salary and benefits package that includes company-subsidized medical, dental, and prescription coverage; pay-for-performance bonuses; and a matching 401K program. Other standard benefits include life insurance, long-term and short-term disability insurance, flexible spending accounts, a tuition reimbursement program, paid time off, and an employee stock purchase program.

Caremark is an Equal Opportunity/Affirmative Action Employer and does not accept unsolicited resumes from agencies.
REQUIREMENTS
Position Requirements: Bachelor Degree in Business or Healthcare Management. 5 years management experience in a pharmacy or medical claims adjudication environment. Knowledge of claim adjudication principles and government regulations in regards to claims processing; understanding of budgeting and human resource policies and procedures; ability to run a high volume production oriented department with an emphasis on quality output in excess of 99% accuracy; excellent verbal and written communication skills; ability to interface with internal and external business partners and clients in a professional manner; ability to make sound operational decisions in a fast paced, high stress environment; ability to effectively manage multiple tasks and projects; good command of Microsoft Office applications, i.e. Word, Excel, Powerpoint.