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 serves as a critical compliance and operational resource responsible for reviewing, researching, validating, and processing requests for member Protected Health Information (PHI). The role ensures compliance with HIPAA, applicable state privacy laws, regulatory requirements, and organizational policies by determining whether requests for access to, use of, or disclosure of PHI are legally permissible and properly authorized prior to the release of records. Responsibilities include supporting member rights requests, legal access requests, subpoenas, court orders, regulatory inquiries, law enforcement demands, and other authorized disclosures of health information
What you will do:
- Review, research, and process requests for member claims records involving Protected Health Information (PHI), ensuring compliance with HIPAA, state privacy laws, company policies, and regulatory requirements.
- Process and fulfill requests submitted to Aetna seeking access to member Protected Health Information (PHI), ensuring all legal, regulatory, privacy, and authorization requirements have been satisfied before records are disclosed.
- Review and validate request documentation to determine eligibility for disclosure and confirm compliance with applicable federal and state regulations.
- Manage and process requests received through:
- Subpoenas and court orders
- Law enforcement requests and demands
- Regulatory agency inquiries and requests
- Legal Access requests
- Member and provider authorizations
- Personal representative requests
- Other legally permitted disclosures of Protected Health Information
- Research and resolve complex or non-routine member rights, disclosure, and privacy requests, escalating matters requiring legal, compliance, or privacy review.
- Ensure confidentiality and security of sensitive member information while adhering to established policies, procedures, and internal controls.
Required Qualifications
- Working knowledge of problem solving and decision making skills
- 2-5+ years’ work experience with Protected Health Information (PHI)
- Excellent verbal and written communication skills
Preferred Qualifications
- Working knowledge of HIPAA Privacy Rule requirements
- Experience reviewing and interpreting legal documents, subpoenas, court orders, authorizations, and regulatory correspondence
Education
- High School Diploma or Equivalent Experience (REQUIRED)
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$18.50 - $38.82This 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.
Skills Required
- Working knowledge of problem-solving and decision-making skills
- 2-5+ years of work experience with Protected Health Information
- Excellent verbal and written communication skills
- High school diploma or equivalent experience
- Working knowledge of HIPAA Privacy Rule requirements
- Experience reviewing and interpreting legal documents, subpoenas, court orders, authorizations, and regulatory correspondence
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 — Health coverage includes medical, dental, and vision with HSA-eligible options, free preventive care, virtual care, and access to MinuteClinic services. Mental-health resources such as counseling support are emphasized, and coverage is often considered solid for full-time colleagues.
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Retirement Support — A dollar-for-dollar 401(k) match up to 5% after one year and an Employee Stock Purchase Plan are consistently highlighted in Total Rewards materials. Feedback suggests retirement programs are a meaningful strength within the overall package.
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Wellbeing & Lifestyle Benefits — Wellbeing offerings include up to 20 no-cost counseling sessions per issue, backup care, tuition assistance, and substantial in-store discounts, alongside broader wellness tools. These everyday perks expand value beyond base pay and can be especially meaningful for full-time schedules.
CVS Health Insights
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.
