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.
In this role as a Senior Eligibility Consultant you will:
Process accurate and timely policy and eligibility data utilizing administration systems for claim payment purposes and product production ensuring services and products meet plan sponsor needs
Collaborate with business partners to understand enterprise initiatives and goals
Respond to eligibility and other enrollment related issues
Partner directly with clients, vendors, internal teams, and/or local claim operation to resolve problems and achieve positive outcomes
Anticipate and prevent problems and roadblocks before they occur
Solve complex problems and take a new perspective on existing solutions
Design, develop, and deliver transitional training processes and procedures to smooth the transition for newly hired employees from formalized classroom training to the department’s production environment; mentor junior team members
Assist with and/or evaluate recommendations involving eligibility reporting solutions and negotiate with internal/external clients
Deliver consulting services in support of data discrepancies and/or involving reporting alternatives
Required Qualifications
2+ years experience as an Eligibility Consultant
Proficiency in processing accurate and timely policy and eligibility data, ensuring services and products meet the plan sponsor needs
Understands intent/end state and operates with minimal guidance to meet that intent/end state
Ability to manage multiple tasks and shifting priorities
A team player capable of operating independently when needed
Provides accurate and timely results
Delegates and follows up as needed
Coaches and mentors others
Ability to manage high work volume and oversee a variety of incoming work flows
Preferred Qualifications
Industry knowledge
Enrollment processing experience
Education
High School diploma, G.E.D. or equivalent experience
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 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: 04/10/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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.
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