Issue Resolution Manager/Manager

Job DescriptionThe Issue Management team oversees operational issues that impact Medicare/Medicaid/Exchange programs where there are regulatory or compliance implications. The IRM partners with Senior IRMs to ensure all remediation tasks for an issue are completed on time to bring issues to closure. The IRM is responsible for partnering with Senior IRMs, business and process owners at all levels to drive timely resolution of reported operational issues with regulatory or compliance implications. This work involves:- Splitting, summarizing, and distributing impact reports both at an individual client and at an aggregate level- Submitting claims for adjustment through Service Warranty processes; obtaining client approvals where needed; monitoring service warranties for completion- Ensuring tasks identified to fully remediate an issue are completed when due, and escalating to senior leaders as appropriate- Posting all issue artifacts into the Issue Management repository (currently SFDC) showing completion of required tasks- Closing issue cases when all tasks are complete, and all evidence of remediation is attached to the caseWhile the operational business areas are responsible for remediating the issue, the IRM will demonstrate a good understanding of Medicare, Medicaid and Exchange requirements.This position requires excellent time management skills to meet stringent timeframes, with strong attention to detail.Required Qualifications3+ years' experience in a PBM work environmentExperience working with Medicare Part D, Medicaid, and/or Exchange programsAdvanced Excel reporting / spreadsheet experienceCOVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred QualificationsSkillful in the use of CRM softwareAttention to detailEducationBachelor's DegreeBusiness OverviewBring your heart to CVS HealthEvery 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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.

Created: 2026-05-02