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<h3> Position Summary </h3> As a Small Business Program Manager, you will execute OSBSDP strategies and solutions to support an enterprise-wide approach to small and diverse business utilization. You will address issues or concerns related to small business and diverse business operations, ensuring alignment with stakeholder interests. Your role will involve ensuring compliance with local, governmental, and industrial regulations in all small business and supplier diversity program processes and operations. Additionally, you will support monitoring, reporting, and evaluating the effectiveness of small business and supplier diversity program implementations. You will also support the execution and implementation of strategies for small business and supplier diversity initiatives, addressing market trends and positively supporting firm-wide growth objectives. Recruiting for this role ends on March 10th,2025 Key Responsibilities: Strategic Growth: In the realm of strategic growth, the Small Business Program Manager will host informative meetings with stakeholders, account teams, and sector small business leads to ensure alignment and foster collaboration. The manager will prioritize top accounts in the assigned GPS Sector based on revenue generation and the level of support from the Office of Small Business and Supplier Diversity (OSBSD). They will identify opportunities to leverage SBIR/STTR and Mentor Protégé program benefits, enhancing the strategic growth initiatives of the program. Developing an in-depth understanding of how Federal clients utilize and engage with small and diverse business teaming partners is crucial, as is developing and maintaining a robust network of these partners for the GPS Sectors. The manager will provide advisory support through all stages of the acquisition process, ensuring that the GPS Sector Growth targets for 2030 are met. Efforts will be scaled through collaborations with Sector SB Advocates, Account Teams, and Account and Sector Leaders, ensuring a cohesive and strategic approach to growth. Marketing &amp; Outreach: In the area of Marketing &amp; Outreach, the Small Business Program Manager will manage the award and recognition processes for the assigned GPS Sector, ensuring that achievements are appropriately acknowledged and celebrated. They will work closely with account teams and sectors to create marketing and outreach opportunities that align with strategic goals. By raising visibility with clients, small and diverse business partners, and industry advocacy groups, the manager will enhance the program's profile and impact. Facilitating relationships with key organizations such as the SBA, DCMA, and client OSDBUs is essential to building a strong network of support and collaboration. Additionally, the manager will lead outreach and marketing efforts to meet both strategic and niche requirements, ensuring that the program's initiatives are effectively communicated and promoted. Small Business Utilization: Under Small Business Utilization, the Small Business Program Manager will provide comprehensive guidance on small business strategy, compliance issues, procedures, and best practices to ensure effective and compliant operations. They will connect with industry and agency representatives to interpret client buying trends, allowing for informed decision-making and strategic planning. The manager will introduce innovative small and diverse teaming partners, fostering a dynamic and inclusive network. They will support efforts to reduce barriers to engagement for small and diverse teaming partners, ensuring equitable opportunities and streamlined processes. Additionally, the manager will conduct bi-monthly reviews with account teams to assess progress on small business goals, providing insights and recommendations to drive continuous improvement and success. Compliance and Reporting: Under Compliance and Reporting, the Small Business Program Manager will support mentor protégé performance and ensure compliance with agreements, fostering successful partnerships. They will ensure accurate and timely reporting on sector engagement with small and diverse business requirements, highlighting achievements and areas for improvement. All remarks on ISRs will include references to Deloitte’s performance with small business goal achievement, showcasing the firm's commitment and progress. The manager will collaborate with Business Intelligence for regulatory reporting, ensuring that all data and reports meet necessary standards and requirements. They will support the drafting of small business plans and provide advice on best practices, ensuring that these plans are robust and effective. Additionally, the manager will ensure that all small business subcontracting plans and participation plans are maintained and current, providing a solid foundation for compliance and strategic growth. Professional Conduct: · Demonstrate the highest level of ethics and professional decorum. · Uphold standards of shared vision, empathy, effective communication, and trust. · Support and implement strategies, policies, processes, and procedures developed through the Office of Small Business. · Emphasize proactive customer service, compliance, and business objectives. · Collaborate proactively with GPS teams to maximize impact. · Enable timely, effective, and proactive communications with coach, team members, and GPCO leadership. · Provide timely, responsive and effective status updates and deliverables. Escalate small business challenges early within direct leadership chain. Success Looks Like: General Interactions &amp; Engagements: Success under general interactions and engagements involves maintaining a comprehensive awareness of sector and account activities, ensuring alignment with program goals and strategic direction. It includes collaborating effectively across functions to foster a cohesive and integrated approach. Providing timely project updates and proactively supporting small business pursuits are crucial for maintaining momentum and achieving objectives. Hosting internal and external stakeholder meetings facilitates communication and collaboration, while prioritizing top accounts ensures focused and strategic efforts. Supporting developmental plans for teaming partners and offering advisory support enhances the capabilities and success of these partners. Additionally, supporting GPS Sector Growth and scaling efforts through collaborations with various teams and leaders are key indicators of success, driving overall growth and achievement of strategic targets. <ol><li> Expected Level of Impact: Success in this role involves seeking opportunities for broader awareness of business strategy and goals, ensuring that all actions are aligned with the overarching objectives. It requires challenging existing practices and bringing in innovative solutions to drive continuous improvement. Applying industry and competitor knowledge to build leading practices is essential for maintaining a competitive edge. Modeling effective teaming and integration across teams and business units fosters a collaborative and cohesive work environment. Managing difficult conversations with stakeholders is a critical skill, ensuring that issues are addressed constructively. Active contribution to coaching, project management responsibilities, and team leadership is vital for developing a high-performing team. Anticipating, identifying, and articulating critical business problems allows for proactive problem-solving. Developing solutions to complex problems and leveraging multiple data sources ensures informed decision-making. Managing ambiguity and demonstrating flexibility are key to navigating changing circumstances. Building powerful narratives to influence and collaborate with stakeholders enhances communication and buy-in. Demonstrating understanding and anticipation of team and client needs ensures that actions are relevant and impactful. Finally, integrating and aligning viewpoints of multiple stakeholders ensures that diverse perspectives are considered and unified towards common goals.</li></ol> Qualifications: Required: · Bachelor’s Degree required. · Min. 6+ years of relevant work experience. · Experience and working knowledge of Federal Acquisition Regulations (FAR) and Agency FAR Supplements. · Strong MS Word, MS Excel, MS PowerPoint, data visualization and data analysis skills. · Ability to travel 5-10%, based on work and client needs. · Must be legally authorized to work in the United States without the need for employer sponsorship. Preferred: <ul> <li>Experience supporting Federal and SLHE clients.</li> <li>Advanced degree or relevant certifications.</li> <li>Proficiency with MS Project, and Visio.</li> <li>Strong consultative and communication skills.</li> <li>Command knowledge of Federal Contracting regulations.</li> <li>Ability to operate in a demanding executive-level environment.</li> <li>Demonstrated ability to work effectively and collaboratively with teams.</li> </ul> This role offers a unique opportunity to contribute to the growth and success of small businesses within the public sector, ensuring compliance, fostering innovation, and driving strategic initiatives. CMG Channel may apply and be considered for the role regardless of US office location. The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $80,400 - $148,000 You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance. Information for applicants with a need for accommodation:<a href="https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html" target="_blank">https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html</a> EA_ExpHire EA_GPS_ExpHire #LI-KW2 Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. <a href="https://www2.deloitte.com/us/en/pages/careers/topics/recruiting-tips.html" target="_blank">Check out recruiting tips from Deloitte recruiters.</a> Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. <a href="https://www2.deloitte.com/us/en/pages/careers/articles/life-at-deloitte-benefits-and-rewards.html" target="_blank">Learn more about what working at Deloitte can mean for you.</a> Our people and culture Our diverse, equitable, and inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/deloitte-inclusion.html" target="_blank">Learn more about our inclusive culture.</a> Our purpose Deloitte’s purpose is to make an impact that matters for our clients, our people, and in our communities. We are creating trust and confidence in a more equitable society. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. We are focusing our collective efforts to advance sustainability, equity, and trust that come to life through our core commitments. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/purpose-at-deloitte-us.html" target="_blank">Learn more about Deloitte's purpose, commitments, and impact.</a> Professional development From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.

Deloitte

Small Business Program Manager, GPS (Government & Public Services)

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 The Enrollment Representative position will be supporting multiple health plans. Under general supervision, verifies enrollment status, makes changes to member/client records, and addresses a variety of enrollment questions or concerns. Maintains enrollment databases and coordinates transfer of non-electronic eligibility data. • Responds, researches, and resolves eligibility and/or billing related issues involving member specific information; •Works directly with clients, field marketing offices and/or local claim operations to achieve positive service outcomes.(*) • Monitors daily status reports assessing output for developing trends potentially impacting service levels. (*) • Applies all appropriate considerations associated with technical requirements, legislative/regulatory policies, account structure and benefit parameters in addressing eligibility matters. (*) • Validates benefit plan enrollment information for assigned clients for accuracy and completeness; coordinates the distribution of membership ID cards and partnering with appropriate internal/external support areas involving any requests for ID card customization. (*) • Completes screen coding and data entry requirements related to the systems processes impacting the generation and release of member-specific and plan sponsor products (e.g., ID cards, change applications, audit lists, in-force lists, HIPAA certificates and various reports). (*) • Completes data entry requirements for finalizing new enrollment information as well as for changes and/or terminations. (*) • When necessary, reviews and corrects transaction errors impacting eligibility interfaces and prepares eligibility/enrollment information for imaging. (*) • Interprets and translates client benefits and supporting account structure against internal systems/applications(i.e.,GEBAR, AAS, and CCI). (*) • Determines and communicates standard service charges to internal/external customers related to paper eligibility activities; May include negotiating and communicating charges pertaining to non-standard services. • Partners with other team functions to coordinate the release of eligibility and benefit plan information; reproduces group bills if requested by clients. Required Qualifications <ul> <li>Attention to detail and accuracy.</li> <li>Problem solving skills.</li> <li>Strong organization skills.</li> <li>Understands the impact of work to other teams and downstream support areas.</li> <li>Ability to analyze and research data to make appropriate corrections as necessary.</li> <li>Strong verbal and written communication skills.</li> <li>Workplace flexibility - ability to adapt to change.</li> <li>Required to maintain work schedule within EST time zone (9:30am- 6:00pm EST).</li> <li>Ability to remain available for overtime, with possible weekend work where needed.</li> </ul> Preferred Qualifications <ul> <li>Knowledge of Health Care and/or MCO’s.</li> <li>Knowledge of Enrollment.</li> <li>Knowledge Medicaid and/or Medicare.</li> <li>Knowledge and comfortability with learning different systems and using Excel (VLOOKUP).</li> </ul> Education <ul><li>High School Diploma or equivalent.</li></ul> Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$17.00 - $28.46This 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. 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 peopleWe 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:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>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.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 03/29/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Eligibility Consultant

<h3> Position Summary </h3> Are you an experienced, passionate pioneer in technology who wants to work in a collaborative environment? As an experienced Epic Certified Professional Billing Expected Reimbursement Contracts Specialist you will have the ability to share new ideas and collaborate on projects as a consultant without the extensive demands of travel. If so, consider an opportunity with Deloitte under our Project Delivery Talent Model. Project Delivery Model (PDM) is a talent model that is tailored specifically for long-term, onsite client service delivery. Work you’ll do/Responsibilities <ul> <li>As a Consultant at Deloitte Consulting, you will be responsible for individually contributing to your work / mentor junior team members along with liaising with onsite/offshore teams to understand the functional requirements.</li> <li>Working on Billing and Contracts Reimbursement configuration and builds by maintaining industry and client standards ensuring build quality and timeline adherence as well as debugging and resolving any issues/defects.</li> <li>Participate in the daily calls / scrum meetings with respect to deliverables and build the weekly status reports to be reviewed with leadership. </li> <li>Resolve issues or incidents reported by end users and escalate any quality issues or risks with team leads/scrum masters/project leaders. </li> <li>This position has responsibility within all phases of patient access application support and optimization including design, build, test, and maintenance of the application</li> <li>This role provides outstanding client service and contributes to the organization’s mission of utilizing information technology to improve patient care</li> <li>Troubleshoot problems and address questions from users and provide on-call support on a rotating basis.</li> <li>Make recommendations, review and test changes, enhancements, and each new release as assigned.</li> <li>Communicate regularly with Engagement Managers (Directors), project team members, and representatives from various functional and / or technical teams, including escalating any matters that require additional attention and consideration from engagement management</li> </ul> The Team Our Core Technology Operations (CTO) team offers differentiated operate services for our clients with solutions to help organizations scale and optimize critical business operations, drive speed to outcome, deliver business transformation, and build resilience in an uncertain future. Qualifications Required <ul> <li>Epic Certification: Must possess current Epic Professional Billing Expected Reimbursement Contracts certification</li> <li>5+ years of experience in IT systems administration, with at least 2 years specifically working with Epic systems.</li> <li>Prior experience working in the Healthcare Industry</li> <li>Bachelor's degree, preferably in Computer Science, Information Technology, Computer Engineering, or related IT discipline; or equivalent experience</li> <li>Limited immigration sponsorship may be available</li> <li>Remote work with the ability to travel 10%, on average, based on the work you do and the clients and industries/sectors you serve. Also, provide on-call support on a rotating basis.</li> </ul> Preferred <ul> <li>Epic Certification: Current Epic Resolute Professional Billing/Epic Resolute Hospital Billing certification</li> <li>Previous Consulting experience</li> <li>Analytical/ decision making responsibilities</li> <li>Analytical ability to manage multiple projects and prioritize tasks into manageable work products</li> <li>Can operate independently or with minimum supervision</li> <li>Excellent written and communication skills</li> <li>Ability to deliver technical demonstrations</li> </ul> Information for applicants with a need for accommodation: <a href="https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html" target="_blank">https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html</a> Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. <a href="https://www2.deloitte.com/us/en/pages/careers/topics/recruiting-tips.html" target="_blank">Check out recruiting tips from Deloitte recruiters.</a> Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. <a href="https://www2.deloitte.com/us/en/pages/careers/articles/life-at-deloitte-benefits-and-rewards-usdc.html" target="_blank">Learn more about what working at Deloitte can mean for you.</a> Our people and culture Our inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. Our purpose Deloitte’s purpose is to make an impact that matters for our clients, our people, and in our communities. We are creating trust and confidence in a more equitable society. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. We are focusing our collective efforts to advance sustainability, equity, and trust that come to life through our core commitments. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/purpose-at-deloitte-us.html" target="_blank">Learn more about Deloitte's purpose, commitments, and impact.</a> Professional development From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.

Epic Certified Professional Billing Expected Reimbursement Contracts Specialist

<h3> Position Summary </h3> Are you an experienced, passionate pioneer in technology who wants to work in a collaborative environment? As an experienced Epic Certified Hospital Billing Expected Reimbursement Contracts Specialist you will have the ability to share new ideas and collaborate on projects as a consultant without the extensive demands of travel. If so, consider an opportunity with Deloitte under our Project Delivery Talent Model. Project Delivery Model (PDM) is a talent model that is tailored specifically for long-term, onsite client service delivery. Work you’ll do/Responsibilities <ul> <li>As a Consultant at Deloitte Consulting, you will be responsible for individually contributing to your work / mentor junior team members along with liaising with onsite/offshore teams to understand the functional requirements.</li> <li>Working on Billing and Contracts Reimbursement configuration and builds by maintaining industry and client standards ensuring build quality and timeline adherence as well as debugging and resolving any issues/defects.</li> <li>Participate in the daily calls / scrum meetings with respect to deliverables and build the weekly status reports to be reviewed with leadership. </li> <li>Resolve issues or incidents reported by end users and escalate any quality issues or risks with team leads/scrum masters/project leaders. </li> <li>This position has responsibility within all phases of patient access application support and optimization including design, build, test, and maintenance of the application</li> <li>This role provides outstanding client service and contributes to the organization’s mission of utilizing information technology to improve patient care</li> <li>Troubleshoot problems and address questions from users and provide on-call support on a rotating basis.</li> <li>Make recommendations, review and test changes, enhancements, and each new release as assigned.</li> <li>Communicate regularly with Engagement Managers (Directors), project team members, and representatives from various functional and / or technical teams, including escalating any matters that require additional attention and consideration from engagement management</li> </ul> The Team Our Core Technology Operations (CTO) team offers differentiated operate services for our clients with solutions to help organizations scale and optimize critical business operations, drive speed to outcome, deliver business transformation, and build resilience in an uncertain future. Qualifications Required <ul> <li>Epic Certification: Must possess current Epic Hospital Billing Expected Reimbursement Contracts certification.</li> <li>5+ years of experience in IT systems administration, with at least 2 years specifically working with Epic systems.</li> <li>Prior experience working in the Healthcare Industry</li> <li>Bachelor's degree, preferably in Computer Science, Information Technology, Computer Engineering, or related IT discipline; or equivalent experience</li> <li>Limited immigration sponsorship may be available</li> <li>Remote work with the ability to travel 10%, on average, based on the work you do and the clients and industries/sectors you serve. Also, provide on-call support on a rotating basis.</li> </ul> Preferred <ul> <li>Epic Certification: Current Epic Resolute Professional Billing/Epic Resolute Hospital Billing certification</li> <li>Previous Consulting experience</li> <li>Analytical/ decision making responsibilities</li> <li>Analytical ability to manage multiple projects and prioritize tasks into manageable work products</li> <li>Can operate independently or with minimum supervision</li> <li>Excellent written and communication skills</li> <li>Ability to deliver technical demonstrations</li> </ul> Information for applicants with a need for accommodation: <a href="https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html" target="_blank">https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html</a> Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. <a href="https://www2.deloitte.com/us/en/pages/careers/topics/recruiting-tips.html" target="_blank">Check out recruiting tips from Deloitte recruiters.</a> Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. <a href="https://www2.deloitte.com/us/en/pages/careers/articles/life-at-deloitte-benefits-and-rewards-usdc.html" target="_blank">Learn more about what working at Deloitte can mean for you.</a> Our people and culture Our inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. Our purpose Deloitte’s purpose is to make an impact that matters for our clients, our people, and in our communities. We are creating trust and confidence in a more equitable society. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. We are focusing our collective efforts to advance sustainability, equity, and trust that come to life through our core commitments. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/purpose-at-deloitte-us.html" target="_blank">Learn more about Deloitte's purpose, commitments, and impact.</a> Professional development From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.

Epic Certified Hospital Billing Expected Reimbursement Contracts Specialist

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 SummaryAetna, a CVS Health company has an outstanding opportunity for a Medical Director. Ready to take your career to the next level with a Fortune 6 company? This is a remote Work at Home position and can be located anywhere in the United States. In this role as Medical Director MPO (Medical Policy &amp; Operations) you will be responsible for providing clinical expertise and business direction in support of medical management programs to promote the delivery of high quality, constituent focused medical care with a focus on clinical and payment policy. This Medical Director provides subject matter expertise to provide clinical support and business direction in these areas. Knowledge of Aetna clinical and coding policy and experience with appeals, claim review, reimbursement issues, and coding is preferable, but a willingness to learn is essential. The Primary Responsibilities of the Medical Director include support of the appeal process, clinical claim review process, pre-certification, and predetermination of covered benefits in the Commercial and Medicare environment. This Medical Director provides subject matter expertise in clinical and payment policy to provide clinical support and business direction in these areas. In this role you will: ◾Participate on work groups as a clinical subject matter expert to identify and promote opportunities to improve the quality and efficiency of health care services. ◾Apply clinical coding and reimbursement expertise to ensure alignment and correct application of Aetna policies and practices to service and payment requests.◾Proactively use data analysis to identify opportunities for quality improvement and positively influence the effective delivery of quality care services. ◾ Be a subject matter expert and internal consultant and payment policy contributor subject matter expertise and internal consultant. ◾Demonstrate the ability to work within and lead as necessary teams comprised of a diverse group of health delivery professionals in order to manage the business objectives of the company. ◾Work Collaboratively with the functional areas. Required Qualifications*Five (5) or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry. *Active and current state medical license without encumbrances. *M.D. or D.O., Board Certification in an ABMS recognized specialty including post-graduate direct patient care experience Preferred Qualifications* Health plan/payor experience. * Foundational baseline skills in Medicine, Health Policy, Coding: HCPCS / CPT, Clinical Policy, Reimbursement and Health Care Systems. * Strong communication skills both written and verbal. Education* M.D. or D.O., Board Certification in an ABMS recognized specialty including post-graduate direct patient care experiencePay RangeThe typical pay range for this role is:$174,070.00 - $374,920.00 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. This position also includes an award target in the company’s equity award program. 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 peopleWe 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:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>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.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Medical Director (Medical Policy & Operations)

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 SummaryAt Aetna, our health benefits business, we are committed to helping our members achieve their best health in an affordable, convenient, and comprehensive manner. Combining the assets of our health insurance products and services with CVS Health’s unrivaled presence in local communities and their pharmacy benefits management capabilities, we’re joining members on their path to better health and transforming the health care landscape in new and exciting ways every day.Aetna is recruiting for an AVP, General Manager who has Medicare market specific P&amp;L accountability for the IVL/DSNP products in their market, supporting Sales and customer experience agendas in market as well as Go-To Market planning and acquisition cost. This position is the leader for market performance, cost structure and local execution of medical costs management, compliance, and revenue integrity efforts for all Medicare Advantage products (inclusive of collaborating with the Employer Group team for EGWP products to achieve sales and client satisfaction goals) in collaboration with corporate teams. The Market GM will drive local product strategy and local market intelligence, be responsible for achieving target market position, market share growth, and drive cost structure reduction (SAIs) in collaboration with Medicare segment leadership, the market medical teams, Network Management teams and other related teams.You'll make an impact by:<ul> <li>Responsibility for supporting Medicare programs with short-and-long term profitability and growth of the health plan. </li> <li>Spearheading the implementation of new contracts, programs, services, and preparation of bid and grant proposals.</li> <li>Responsibility for the overall financial performance and achievement of the budget of the Medicare plans within the Market.</li> <li>Direction of senior leaders of specific functional areas as assigned. Functional areas may include operations, sales, marketing, provider relations, network development, utilization management, and/or STARS/HEDIS quality improvement, and Revenue Integrity efforts. Coordinating and monitoring functional integration of these areas in cooperation with corporate departments to achieve planned business results.</li> <li>Leading all departments in the development, implementation and maintenance of policies and procedures to ensure compliance with the State and Federal regulatory requirements.</li> <li>Responsibility for the plan performance related to all required State and Federal audits.</li> <li>Responsibility for the management and organization of plan activities at the health plan as it relates to the Medicare business.</li> <li>Monitoring the budget in assigned functional areas and takes corrective actions when necessary.</li> <li>Leading and developing people, preferably leading managers. Proven team leadership experience - leadership skills to build high-performing teams, manage and develop talent, influence, and impact a broad set of stakeholders, engage, and inspire others, and lead by example. Ability to lead teams and drive performance in a dynamic and fast-paced environment.</li> <li>Partnering effectively within the team and across the organization to ensure strategic initiatives stay aligned to plan and elevate solutions to barriers and decisions needed to executive leaders at the highest levels of organization.</li> <li>Creating and executing a sustainable, and profitable-growth strategy.</li> <li>Accountability for working with Medicare segment functional areas for monthly results, bid execution and other MAO responsibilities.</li> <li>Supporting CVS Health in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve.</li> </ul> Required QualificationsThe candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company’s business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes:<ul> <li>10+ years of relevant experience in line of business management.</li> <li>Deep knowledge of the Medicare business.</li> <li>Must have P&amp;L expertise and possess a strong financial, bottom-line focus.</li> <li>Ability to deal effectively with multiple internal and external clients.</li> <li>Ability to effectively interact with a diverse workforce and cross functional groups.</li> <li>Strong facilitative leadership and business problem solving skills are required.</li> <li>Ability to deal effectively with multiple internal and external clients is required.</li> <li>Knowledge of insurance regulatory and contractual requirements.</li> <li>Knowledge of value based provider contracting.</li> <li>Knowledge of current health care marketplace dynamics and Aetna’s position in the market.</li> <li>Knowledge of Aetna’s operations and marketing processes and strategies.</li> <li>Ability to effectively interact with a diverse workforce and cross functional groups required.</li> <li>Experience leading and developing people, preferably leading managers. Proven team leadership experience - leadership skills to build high-performing teams, manage and develop talent, influence, and impact a broad set of stakeholders, engage, and inspire others, and lead by example. </li> <li>Skilled at collaborating and working across a complex matrixed organization. </li> <li>Residence in/near the market (New York or New Jersey) or willing to relocate.</li> <li>Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.</li> </ul> Education Bachelor’s degree in business, healthcare administration, or a related field.Pay RangeThe typical pay range for this role is:$157,800.00 - $363,936.00 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. This position also includes an award target in the company’s equity award program. 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 peopleWe 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:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>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.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 04/11/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

AVP, General Manager - Medicare - NY/NJ

<h3> Position Summary </h3> Tired of Tax Compliance and Busy Season? You’ve earned your stripes as a tax specialist and tapped into the world of cutting-edge tax technology. You are not an expert in technology, but you can offer profound insight about how U.S. federal income tax models and computations work. If you have a passion for improving computational software applications and proprietary solutions, we have the career opportunity to keep you buzzing! Work You’ll Do: As a Tax Sr. Manager in our Partnership Solutions Group, Operational Partnership Services team you will: <ul> <li>Refine your skillset with the ability to work with large-scaled operating partnership tax clients on matters that mean the most to them.</li> <li>Diversify your industry experience by working on a plethora of various industries including private equity, healthcare, tech, financial products, oil &amp; gas, green energy, real estate, consumer products, and other various industries.</li> <li>Deliver value to client experiencing a public offering (including SPACs) and interact with external counsel, underwriters, client executives, and capital market professionals through the SEC public filing process.</li> <li>Assist our client with public offering transactions including but not limited to initial proxy and registration statements for Up-C and SPAC structures.</li> <li>Work with Up-C clients on an on-going basis during periodic service periods during the year.</li> <li>Develop an understanding of the public monetization transactional process, including tax receivable agreements.</li> <li>Create cutting-edge technology that evolves around U.S. federal income tax principles for partnership tax, data analytics, and the user experience.</li> <li>Lead engagement teams and have the opportunity to work with highly motivated and dedicated teams. Mentor and develop of engagement staff, providing leadership, counseling, career guidance, and guidance on issues related to work/life fit.</li> <li>Implement strategic tax structures and processes, and oversee complex tax computation projects for clients, with emphasis on identification and communication of technical tax and service issues.</li> <li>Determine and solve for complexities with the U.S. federal income tax impact of public offerings.</li> <li>Participate in marketplace activities, recruiting, and process and technology innovation.</li> <li>Identify service opportunities, manage client accounts, and advance various Deloitte initiatives.</li> </ul> The Team: National Federal Tax Services (NFTS) is a national practice within Deloitte Tax LLP made up of a number of tax service offerings. Each NFTS service offering has been developed and built as a result of a tax planning idea, a marketplace driver, or a technological innovation - all with the purpose of delivering results for our clients. Our people are entrepreneurial in spirit and have always had the work-hard/play-hard mentality. NFTS service lines provide tax planning for the largest organizations across all industries. In the Operational Partnership Services (OPS) service line, which is a part of the Partnership Solutions Group within NFTS, OPS professionals counsel privately-held and publicly-traded partnerships across the United States on a wide range of federal tax and issues involving Up-C, mergers, acquisitions, divestitures, initial public offerings (IPO), post-offering assistance, and process design and improvement. Industries served by the Operational Partnership Services practice include private equity, real estate, telecom, technology, healthcare, media &amp; entertainment, energy, retail, and financial services that frequently involve asset management, venture capital, and international outbound joint ventures. Come join the team! Qualifications: Required: <ul> <li>Ability to perform job responsibilities within a hybrid work model that requires US Tax professionals to co-locate in person 2 – 3 days per week</li> <li>8+ years of experience in federal partnership tax</li> <li>Bachelor’s degree in accounting or other business-related field required</li> <li>Proven leadership skills demonstrating strong judgment, problem-solving, and decision-making abilities</li> <li>Proven management experience indicating strong organizational skills and the ability to plan and manage budgets and workplans</li> <li>Demonstrated U.S. federal income tax partnership experience</li> <li>Ability to travel up to 25%, on average, based on the work you do and the clients and industries/sectors you serve</li> <li>One of the following, active accreditations obtained:</li> <ul> <li>Licensed CPA in state of practice/primary office if eligible to sit for the CPA</li> <li>If not CPA eligible:</li> <ul> <li>Licensed Attorney</li> <li>Enrolled Agent</li> <li>Certifications:</li> <ul> <li>Chartered Financial Advisor (CFA)</li> <li>Certified Financial Planner (CFP)</li> </ul> </ul> </ul> </ul> Preferred: <ul> <li>Advanced degree such as master’s in science of tax (MST), JD, or LLM</li> <li>Previous Big 4 or large CPA firm experience</li> <li>Aptitude in MS Project, Word, Excel, and Visio</li> <li>Transaction and M&amp;A experience</li> <li>Alteryx experience</li> <li>Self-starter with demonstrated ability to effectively handle multiple, competing priorities</li> <li>Numerical-problem-solving focus</li> <li>Demonstrated effective verbal and written communication skills</li> </ul> The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $103,320 to $235,170. You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance. Information for applicants with a need for accommodation: <a href="https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html" target="_blank">https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html</a> nftstax btstax Recruiting tips From developing a stand out resume to putting your best foot forward in the interview, we want you to feel prepared and confident as you explore opportunities at Deloitte. <a href="https://www2.deloitte.com/us/en/pages/careers/topics/recruiting-tips.html" target="_blank">Check out recruiting tips from Deloitte recruiters.</a> Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. <a href="https://www2.deloitte.com/us/en/pages/careers/articles/life-at-deloitte-benefits-and-rewards.html" target="_blank">Learn more about what working at Deloitte can mean for you.</a> Our people and culture Our diverse, equitable, and inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/deloitte-inclusion.html" target="_blank">Learn more about our inclusive culture.</a> Our purpose Deloitte’s purpose is to make an impact that matters for our clients, our people, and in our communities. We are creating trust and confidence in a more equitable society. At Deloitte, purpose is synonymous with how we work every day. It defines who we are. We are focusing our collective efforts to advance sustainability, equity, and trust that come to life through our core commitments. <a href="https://www2.deloitte.com/us/en/pages/about-deloitte/articles/purpose-at-deloitte-us.html" target="_blank">Learn more about Deloitte's purpose, commitments, and impact.</a> Professional development From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.

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