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Eligibility Analyst

AT CVS Health
CVS Health

Eligibility Analyst

Northbrook, IL

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Position SummaryCVS/Caremark, the Pharmacy Benefit Management (PBM) division of CVS Health, is looking for an Enrollment Analyst to join our Eligibility Administration Department. As an Enrollment Analyst for a Fortune 10 organization, you will impact and support customers in all areas including Commercial, Medicare, Healthcare Plans & Group Waiver Plans (EGWP).

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Primary responsibilities of the Enrollment 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 Enrollment Consultant is able to exceed client expectations in this fast-paced environmentRequired Qualifications- 1 year 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

Preferred Qualifications- 3 years in eligibility or other relevant background
- 2 years customer service or client-facing experience in a fast-paced environment
- Experience in EDI (Electronic Data Interchange)
- Understanding of the PBM industry
- Experience in a healthcare client facing role
- Experience in a fast paced environment
- Knowledge of ANSI X12 834 Data Documents
- Familiarity with RxClaim and/or AS400

- Bachelor's Degree preferredEducationHigh School Diploma or equivalent GED required 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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS HealthWe anticipate the application window for this opening will close on: 02/28/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Northbrook, IL 60062, USA
Job ID: CVS-R0486768
Employment Type: Other

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • HSA
    • HSA With Employer Contribution
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Fertility Benefits
    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
  • Financial and Retirement

    • 401(K) With Company Matching
  • Professional Development

    • Tuition Reimbursement
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Diversity, Equity, and Inclusion Program