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.
Job Summary:
Build and maintain a solid team through training, coaching and developing staff
Validate effectiveness of the different projects managed by appeals team through universe data validation.
Facilitate and present at meetings within the Appeals team.
Establish and maintain in collaboration with the business, consistent processes defining the overview and readiness of appeals to help remain compliant with regulatory and accreditation requirements.
Assess developmental needs and collaborate with others to identify and implement action plans that support the development of high performing teams and individuals.
Manage projects and identify trends and recommends/acts on solutions.
Report capabilities related to audit requests and universe submissions.
Required Qualifications
3+ years Appeals background
Microsoft Office experience
Knowledge of Appeals job aids/workflows
Strong Communication skills - ability to provide and receive feedback
Excellent time management skills
2+ years of supervisory experience
Ability to work collaboratively across teams
Strong analytical skills focusing on accuracy and attention to details
Preferred Qualifications
2+ years Project Management experience
QuickBase experience
2+ years training or leadership experience
Knowledge of CMS guidance
Product knowledge and experience with Appeals and Medicare Regulatory Requirements
Appeals and MHK knowledge/experience
Education
High school diploma or higher education
Bachelor's degree or equivalent experience
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$54,300.00 - $159,120.00This 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.
Skills Required
- 3+ years of appeals experience
- Microsoft Office experience
- Knowledge of appeals job aids and workflows
- Strong written and verbal communication skills
- Excellent time management skills
- 2+ years of supervisory experience
- Ability to collaborate across teams
- Strong analytical skills with accuracy and attention to detail
- 2+ years of project management experience
- QuickBase experience
- 2+ years of training or leadership experience
- Knowledge of CMS guidance
- Appeals and Medicare regulatory requirements product knowledge and experience
- Appeals and MHK knowledge or experience
- High school diploma or higher education
- Bachelor's degree or equivalent experience
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.
