Description
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 Summary* The Analyst, Commercial R&R role performs claims reverse and reprocessing (R&R) to address benefit coding errors, eligibility changes, program features, and client requests. This reprocessing is a vital step in the Adjustment or Service Warranty process. This entails resolving rejects and QA fails, obtaining multiple levels of approvals, and closing out the cases in a timely manner to issue financial impacts to members, clients, and pharmacies. This activity touches millions of claims a year and has wide organizational impacts. This role is required to manage an individual queue of multiple projects in a fast-paced, process-driven environment. Attention to detail, excellent communication, and time-management skills are essential. Analysts work closely with multiple internal departments such as Sales, Account Management, IT, Medicare Part D Services, Client Audit, Benefits, and Implementations to manage and coordinate the work. *Required Qualifications* * 1+ years of financial or healthcare experience * 1+ years of analytical experience with large data sets *Preferred Qualifications* * PBM Industry and plan design. RxClaim adjudication or benefits knowledge. * Medicare Part D - PBM or claim adjudication knowledge. * Understanding of data sets, tables/files, queries, joins, and other database concepts. * Strong customer service focus that includes both internal and external customers. * Excellent verbal and written communication skills. * Highly desired Excel skills include ability to manage and present large volumes of data, creating/using complex formulas, report formatting, pivot tables, data manipulation, and other advanced functions. * 1+ years of healthcare experience *Education* * Verifiable Bachelors degree or equivalent experience required *Business Overview* At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. *Pay Range* The typical pay range for this role is: $40,600.00 - $89,300.00This 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 [jobs.CVSHealth.com/benefits](https://jobs.cvshealth.com/benefits) We anticipate the application window for this opening will close on: 05/03/2024
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