At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary
As a Client Benefit Representative II you will be responsible for analyzing client requests and performing the necessary benefits coding and quality assurance activities. You'll work alongside team responsible for coding, testing, and performing quality assurance, as well as our implementation Management team to deliver high quality support to our clients. Extreme attention to details is important for this role, as your coding and quality assurance activities will impact commercial clients at CVS Health. You will be expected to execute with high level of accuracy, responsiveness, and reliability while performing job functions What you will do
Want more jobs like this?
Get Computer and IT jobs in Hartford, CT delivered to your inbox every week.
• Configures benefits programs within the healthcare company's systems or databases.
• Follow policies and best practices relating to the job function by analyzing client requests, determine the best operational approach and install adjudication related drug lists (eg formulary, clinical edits, plan coverage, etc) in Salesforce and Rxclaim/AS400
• Processes member or subscriber enrollments into the benefits programs by entering enrollment data, verifying eligibility based on plan requirements, and ensuring accurate and timely enrollment for individuals or groups.
• Able to meet all turnaround time and performance guarantees with excellent quality
• Ability to collaborate regularly with peers to audit, review and verify drug list coding and testing while utilizing various tools
• Ensures the accuracy and integrity of data related to benefits program setup by reviewing and validating data entries, performing data audits, and making corrections or updates as needed to maintain accurate and up-to-date information.
• Organizes documentation and records of benefits program setup activities, including plan configurations, enrollment data, eligibility determinations, and any modifications or updates made.
• Assists in providing regular, timely feedback to ensure delivery of exceptional services and engagement, motivation, and team development.
Communicates with various internal teams, such as benefits administration, HR, or IT, to gather and exchange information related to benefits setup and enrollment Requirements
- 2-3 years of direct work experience with PBM knowledge
- Proficient use Microsoft Office applications, e.g. Excel, Word
- Experience with AS400 / RxCLAIM
- Working knowledge of SalesForce.com
- Certified Pharmacy Technician
- Well organized with the ability to prioritize work
effectively and independently - Flexible in adapting to change
- Excellent time management skills
- Excellent interpersonal and collaborative skills with the ability to work in a team environment
- Ability to work successfully in a deadline-oriented environment
- Excellent verbal and written communication skills
- Strong analytical skills and attention to detail. Ability to define problem, review data, establish facts, and draw valid conclusions
• High School Diploma Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:$17.00 - $31.30This 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 peopleWe 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.