At CVS Health, you'll be surrounded by colleagues who care deeply, innovate with purpose, hold themselves accountable and prioritize safety and quality in everything they do.

Position Summary

• Provides plan benefit review, interpretation, and systematic setup, essential for online viewing and processing, related to customer service, claims, enrollment, billing, and reporting, in support of internal and external partners.
• Utilizes Meritain's proprietary system for analytical coding of detailed customized plans.
• Develops and executes implementation strategy consistent with client expectations; ensures strategy is administered in accordance with all performance guarantee arrangements.
• Consults and advises internal stakeholders on complex benefit administration.
• Uses business knowledge and experience to make plan design and processing recommendations when working with clients.
• Reviews benefit provisions to ensure compliance with state and federal mandates.
• Collaborates on review, analysis, and development of recommendations for the design of complex account and benefit structures.
• Executes system setup and mapping of client level benefits to align with industry coding.
• Solicits and assesses internal and external customer feedback to drive continuous quality improvement.
• Demonstrates Salesforce proficiency and understanding for cross-functional communication and enables executive-level status reporting.

Required Qualifications

• 2+ years of experience working with healthcare, specifically with quality, renewals, client advocacy, and/or account management.
• Ability to work Monday-Friday from 8am-5pm, with the ability to work beyond those core hours during busy seasons.

Preferred Qualifications

• 5+ years of experience working with healthcare, specifically with quality, renewals, client advocacy, and/or account management.
• Previous experience with Salesforce.
• Previous experience with various data systems, including DOS systems.
• Strong analytical and problem-solving skills.
• Excellent organization skills and ability to quickly prioritize multiple assignments with high quality results.
• High attention to detail and accuracy.

Benefits

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs.

Anticipated Weekly Hours

• 40

Time Type

• Full time

Pay Range

• $46,988.00 - $122,400.00

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