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
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)
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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
CVS Health Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about CVS Health and has not been reviewed or approved by CVS Health.
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Healthcare Strength — Healthcare coverage is positioned as comprehensive for benefits-eligible colleagues, including medical, dental, and vision with free preventive care and access to virtual care and select no-cost MinuteClinic services. Mental health support is also highlighted with no-cost confidential counseling sessions per issue.
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Retirement Support — Retirement benefits include a 401(k) with a dollar-for-dollar match up to 5% after meeting service and hours requirements. Ownership programs are also offered through an employee stock purchase plan with a stated purchase discount.
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Pay Growth & Progression — A companywide minimum wage floor establishes a baseline that is framed as a positive starting point in some roles and markets. Unionized or high-cost areas are described as having clearer wage scales and step-ups that can materially lift pay over time.
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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.
