Manager, Resource Planning / Workforce Management

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

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.

You will be responsible for leading and directing a diverse team to promote outcomes related to service performance, customer satisfaction, financial performance, and quality. You will also require responsiveness to customer service escalations related to missed metrics. You will collaborate with upstream and downstream functional areas to support clients as well as enterprise products. You will provide leadership and oversight of key Resource Planning teams and their corresponding operational functions. You will be responsible for leading the implementation, compliance, delivery, and execution of CGSO Workforce strategies and initiatives. This includes supporting timekeeping, attendance, scheduling, and workflow management for inbound, outbound, and offline workload. You will have direct reports with oversight of Resource Planning colleagues in support of approximately 2000+ CGSO colleagues in multiple lines of business (LOB) across all CVS Health locations and work from home (WFH). You will be responsible for driving operational performance metrics by line of business to ensure call center metrics are met as well as driving colleague productivity, quality, development, and engagement. You must have critical thinking skills and superior problem-solving capabilities to root cause and pursue possible enterprise solutions. Other duties will be required to meet business needs. In this position you will operate with a high level of flexibility to meet the demands of a production environment, regulatory/accreditation landscape, and client customization. You will be accountable for all financial, regulatory, and operational outcomes, colleague and team development, and expected to collaborate with all peers and colleagues at all levels to ensure adoption with all new and existing client implementations, testing and maintenance of workforce applications such as, but not limited to: Verint, WorkBrain, Mattersight, Avaya CMS, Five9, Avaya Proactive Dialer, and Nice Dialer. You will be accountable for achieving the operational targets for call center and back office service performance, ensuring operational hiring is on plan to budget, and assist with improving employee productivity to plan. You must be creative in finding resolutions when performance metrics are not aligned, be agile to change direction, and deliver results that fall within acceptable range.

You will be accountable for leading and achieving the following business objectives

• 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.

This is a remote role and candidates can live anywhere in the U.S.

Required Qualifications

• 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.

Preferred Qualifications

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

Education

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

Pay Range

The typical pay range for this role is

$54,300.00 - $145,860.00

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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS Health (~~~)

We anticipate the application window for this opening will close on: 11/26/2024

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

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.