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.

Summary

The Senior Representative role is designed for a seasoned professional who excels in resolving complex and escalated member issues with precision, empathy, and urgency. This position is central to the success of the team, and as a reliable backup for leadership. The ideal candidate will be a proactive problem-solver, a confident communicator, and a collaborative partner across teams.

Key Responsibilities

Complex Member Issue Resolution

Serve as the senior contact for escalated member issues requiring advanced problem-solving and cross-functional coordination.
Deliver high-quality resolutions with professionalism, empathy, and urgency.
Document and analyze member interactions to identify trends and ensure compliance with service standards.
Provide support and guidance to junior team members handling complex cases.

Team Support

Act as a senior resource, offering real-time support and solutions to representatives managing challenging member inquiries.
Triage and prioritize incoming requests, ensuring timely and effective responses.
Support critical issues appropriately and follow through to resolution.
Lead mentorship and training of junior support staff, fostering a culture of excellence and continuous learning, including providing Subject Matter Expertise through SME Tickets and/or  Rep Assist
Lead onboarding and training sessions for new hires, ensuring alignment with quality standards and operational procedures.
Deliver refresher training based on identified gaps or evolving processes.

Leadership Backup & Collaboration

Provide backup support for leaders during peak times, absences, or special initiatives.
Collaborate with leadership to align on service goals, priorities, and escalation protocols.
Participate and lead team huddles, strategy sessions, and process improvement initiatives.
Support leadership with team communications and reporting.

Peer Quality Reviews

Conduct peer-to-peer quality audits to assess accuracy, compliance, and service delivery.
Collaborate with leadership to calibrate quality standards and ensure consistency across the team.

Continuous Improvement & Development

Identify recurring issues and recommend process enhancements to improve member experience.
Engage in ongoing training to deepen expertise in strategic communication, data interpretation, and client engagement.
Review all team processes for accuracy and make updates.

Qualifications
Required

4–6 years of experience in member support, healthcare, insurance, or benefits.
Strong communication, critical thinking, and relationship-building skills.
Proven ability to resolve complex issues and support team operations.

Preferred

Associate's degree in Business, Healthcare Administration, or related field.
Experience supporting leadership or managing escalations.
Familiarity with CRM platforms, reporting dashboards, and SOP documentation.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $35.29

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. 
 

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 people

We 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:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• 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.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 12/31/2025

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