We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary
This position involves research, resolution, and data entry correction to ensure the pharmacy adjudication system’s eligibility data matches the Aetna enrollment applications data, which is the source of truth. The role entails managing shared mailboxes and work queues resolving issues from a variety of areas within the company; researching and resolving errors from various reports; reconciling eligibility between systems; file tracking and monitoring; and collaboration with a variety of internal and external areas to create efficient resolutions to resolve issues.

Key Responsibilities

• Research and resolve Pharmacy Eligibility inquiries in an accurate and timely manner utilizing various tools and resources
• Communicate clearly and concisely with internal partners such as: customer service representatives, enrollment consultants, plan coordination consultants, plan sponsor liaisons, account managers, internal and external auditors
• Updating member data within the appropriate system to reflect correct demographic and eligibility information
• Ensuring daily eligibility files transfer successfully between the Health Plan and the Pharmacy Benefit Manager
• Tracking and trending daily files, errors and suspended records
• Follow detailed work instructions for all facets of job responsibilities
• Effectively prioritize multiple assignments to meet the designated turn-around-times and maintain quality standards
• Identify and report trends or emerging issues
• Be open and enthusiastic to change; embrace new technology/processes

Required Qualifications

• 1-2 years related experience
• Experience in data research and analysis
• Health care industry experience
• Working knowledge of Microsoft Office products (Word, Excel, MS Access, PowerPoint, Outlook, Project)
• Excellent verbal, problem solving, and written communication skills

Preferred Qualifications

• Experience using Member Enrollment Application (MEA), Data Migrator Direct (DMD), Web CCI, RxClaim

Education

• High School Diploma

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$17.00 - $34.15

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 07/28/2026

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