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Job Details

CVS Health

Eligibility Analyst (2133822BR)





Irving, Georgia, United States

Job Description
CVS/Caremark, the Pharmacy Benefit Management (PBM) division of CVS Health, is looking for an Eligibility Analyst to join our Eligibility Administration Department. As an Eligibility Analyst for a Fortune 10 organization, you will impact and support customers in all areas including Commercial, Medicare, Healthcare Plans & Group Waiver Plans (EGWP).

Primary responsibilities of the Eligibility 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 Eligibility Analyst is able to exceed client expectations in this fast-paced environment

Pay Range
The typical pay range for this role is:
Minimum: 40,600
Maximum: 81,100

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications
- 4+ years in healthcare data eligibility, insurance, IT, benefits or data analytics environment

COVID Requirements

COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications
- 4+ years in Eligibility Administration or other relevant background
- 3+ 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

- High School Diploma or GED required

Business Overview
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.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.