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

Eligible to Apply Anywhere in US
Position is eligible to be fully remote

This position is with our Centralized External PBM Integration team supporting National Accounts and Local Markets external integration by keeping member’s accumulators in sync with our third party pharmacy and/or behavioral health carriers. The team is focused on Our Common Purpose and dedicated to continuous process improvement. These Analysts advocate for members by proactively identifying and collaborating with internal business and external vendors for any discrepancies. Analysts help members get the most from their benefits by handling inventory promptly and reducing the risk of the member paying out of pocket unnecessarily. Analysts build trust by ensuring accuracy in the member’s accumulators by working closely with third party vendors to reconcile and stay in sync with financials. Analysts help to provide a clear path to care by supporting our CSR, PSL and Account Managers with member inquiries or questions around external integration.

JOB RESPONSIBILITIES:
• Update member’s financial accumulators with data received from external business partners
• Forward claims for rework when necessary
• Review, track and forward escalations to necessary parties.
• Respond to external business partner’s questions.
• Excel working in a production environment to ensure timely handling and completion of assignments.
• Perform analysis of data to identify and communicate trends.
• May perform or assist with special projects.
• Demonstrate exceptional interpersonal skills, professionalism and customer service orientation.

Required Qualifications

Functional Experiences:
• 1-3+ Years ACAS Claims/Accumulator Processing/Experience
• 1-3+ Years experience in Aetna Standard Plans

Technology Experiences:
• 1-3+ Years (Electronic Workflow Manager)
• 1-3+ Years Experience Web CCI ( Customer Coverage Inquiry (web) )
• 1-3+ Years Experience in MS Office Suite.

Required skills:
• Qualified candidates must have excellent verbal and written communication abilities.
• Demonstrate the ability to effectively collaborate with others to achieve desired results.
• Critical thinking, time management, decision making, problem solving and organizational skills.
• Work cross functionally to deliver quality service to our internal and external customers.
• Adapt communications to meet the needs of the intended audience.
• Ability to be flexible and creative in a fast paced, constantly changing environment.

Education

• High School diploma, G.E.D. or equivalent experience.

Pay Range

The typical pay range for this role is:

$18.50 - $31.72

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: 10/22/2024

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