Skip to main contentA logo with &quat;the muse&quat; in dark blue text.

Grievance Analyst (Caseworker)

AT CVS Health
CVS Health

Grievance Analyst (Caseworker)

Phoenix, AZ

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 SummaryCVS Health has an exciting new opportunity within the Grievances team in Scottsdale, AZ. As a Grievance Analyst, you will be responsible for researching, resolving, and communicating any issues, questions, or concerns our members have about their coverage and benefits provided through Medicare Part D.You will have the opportunity to work cross functionally with different departments within CVS Health to support the research into these members' issues. Once resolved you will be responsible for outreach to each member with a verbal and/or written response explaining the resolution of the issues.

Want more jobs like this?

Get jobs in Phoenix, AZ delivered to your inbox every week.

By signing up, you agree to our Terms of Service & Privacy Policy.


As you support our Med D members, we will support you by offering all the tools and resources you need in a collaborative team-based environment. Our goal is to ensure you can provide top tier service and resolution for our members. We use our own emphasis on quality as well as government mandated turnaround times to ensure we do our job effectively, always focusing on helping people on their path to better health.In order to be successful in this role you will need to be detail-oriented with proficient research skills and demonstrate the ability to analyze data, apply learnings, and construct a resolution in a timely manner. A successful Analyst is receptive to constructive feedback and flexible in adapting to change while effective in planning, prioritizing, and organizing their time and workload to achieve production goals and turnaround time requirements. Analysts are expected to close grievances cases daily, close 15-20 cases per week (depending on inventory) and close all cases within 25 days of TAT while maintaining the highest quality standards. In this position you will be measured by your ability to use your judgement to execute to reach these department goals.Additional responsibilities of the Analyst include creatively constructing written formal communication to members, multitasking, and working with up to 15 various computer applications and documenting the issue and resolutions in the database, while adhering to the strict turnaround times established by the Center for Medicare and Medicaid Services (CMS).Required Qualifications- 2 plus years of experience working within a customer service role on several computer applications and complex databases for research, including Microsoft Office products (Excel, Word, and Outlook).Preferred Qualifications- Previous experience within Pharmacy Benefit Management (PBM) or pharmaceutical related industry.

- Previous Med D grievance experience.

- Bachelors Degree Preferred.EducationHigh School Diploma or equivalent General Education Degree (GED) Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$43,888.00 - $85,068.00This 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 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.
For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 03/28/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Phoenix, AZ, USA
Job ID: CVS-R0522588
Employment Type: Full Time

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