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
The Analyst role performs claims diagnosis to identify claims impacted by plan benefit changes. This diagnosis is a vital step in the Service Warranty process which begins with reviewing the parameters of an issue and then running AS400 queries in order to identify the impacted claims. Depending on the type of case submitted, this position's daily tasks include pulling impacted claims to convert/submit for R&R and pulling impacted claims to complete a subsequent manual analysis in Excel. This work identifies and issues financial impacts to clients, members, and pharmacies due to benefit coding errors, eligibility changes, program features, and client requests.
This role is required to manage an individual queue of multiple projects in a fast-paced, process-driven environment and excellent communication and time-management skills are essential. At times, the work completed will need to be presented and explained to other parties.
You will work closely with Sales, Account Management, Client Audit, Benefits, Clinical, Rebates, and other teams to manage and coordinate the work.
Required Qualifications
- 1+ years of healthcare experience
- 1+ years of Excel experience
Preferred Qualifications
- Understanding of data sets, tables/files, queries, joins, and other database concepts
- Strong customer service focus that includes both internal and external customers.
- Excellent verbal and written communication skills.
- PBM Industry and plan design.
- RxClaim adjudication or benefits strongly preferred.
- Candidates that have CVS Caremark PBM adjudication/systems, LINKS/Mail order, AS400/mainframe, or other relevant experience are highly desired.
- Preferred experience includes business operational experience that includes high volume transactional experience.
- Highly desired Excel skills include ability to manage and present large volumes of data, creating/using complex formulas, report formatting, pivot tables, data manipulation, and other advanced functions.
Education
- Bachelor's Degree or equivalent experience
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$43,888.00 - $93,574.00This 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: 03/28/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
