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.

POSITION SUMMARY

CVS/Caremark, the Pharmacy Benefit Management (PBM) division of CVS Health, is looking for an Eligibility Analyst to join our Eligibility Administration Department. As an Eligibility Analyst for a Fortune 10 organization, you will impact and support customers in all areas including Commercial, Medicare, Medicaid, & Healthcare Plans.

Primary responsibilities of the Eligibility Analyst include:

• Acting as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocol for clients
• Researching and consulting to improve healthcare data integrity and ensure excellent service delivery
• Constantly improving healthcare analytical skills that are needed to perform data analysis
• Resolving data enrollment issues on a daily basis
• Consulting on healthcare data needs
• Having exceptional time management and healthcare client management skills
• Continuous development training will be provided in this role to ensure the Eligibility Analyst is able to exceed client expectations in this fast-paced environment

REQUIRED QUALIFICATIONS

• 1+ year(s) in healthcare data eligibility, insurance, IT, benefits, or data analytics environment with a strong ability to work independently, problem solve, and analyze data in a confidential healthcare environment
• 2+ years customer service experience in a fast-paced environment
• Strong written and verbal communication skills
• Ability to communicate with business clients and stakeholders in a professional manner

PREFERRED QUALIFICATIONS

• 3+ years experience in eligibility or other relevant background
• Experience in EDI (Electronic Data Interchange)
• Understanding of the PBM industry
• Familiarity with RxClaim and/or AS400
• Pharmacy technician or benefits verification experience

EDUCATION

High School Diploma (required); Associate’s degree or 2 years of PBM or healthcare experience (preferred)

• Acting as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocol for clients
• Researching and consulting to improve healthcare data integrity and ensure excellent service delivery
• Constantly improving healthcare analytical skills that are needed to perform data analysis
• Resolving data enrollment issues on a daily basis
• Consulting on healthcare data needs
• Having exceptional time management and healthcare client management skills
• Continuous development training will be provided in this role to ensure the Eligibility Analyst is able to exceed client expectations in this fast-paced environmen