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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

In this role as a Senior Eligibility Consultant you will:

• Process accurate and timely policy and eligibility data utilizing administration systems for claim payment purposes and product production ensuring services and products meet plan sponsor needs

• Collaborate with business partners to understand enterprise initiatives and goals

• Respond to eligibility and other enrollment related issues

• Partner directly with clients, vendors, internal teams, and/or local claim operation to resolve problems and achieve positive outcomes

• Anticipate and prevent problems and roadblocks before they occur

• Solve complex problems and take a new perspective on existing solutions

• Design, develop, and deliver transitional training processes and procedures to smooth the transition for newly hired employees from formalized classroom training to the department’s production environment; mentor junior team members

• Assist with and/or evaluate recommendations involving eligibility reporting solutions and negotiate with internal/external clients

• Deliver consulting services in support of data discrepancies and/or involving reporting alternatives

Required Qualifications

• Experience as an Eligibility Consultant

• Proficiency in processing accurate and timely policy and eligibility data, ensuring services and products meet the plan sponsor needs

• Understands intent/end state and operates with minimal guidance to meet that intent/end state

• Ability to manage multiple tasks and shifting priorities

• A team player capable of operating independently when needed

• Provides accurate and timely results

• Delegates and follows up as needed

• Coaches and mentors others

• Ability to manage high work volume and oversee a variety of incoming work flows

Preferred Qualifications

• Experience as an Eligibility Consultant

• Industry knowledge, enrollment processing experience, and experience in coaching or mentoring others

Education

High School diploma, G.E.D. or equivalent experience

Pay Range

The typical pay range for this role is:

$18.50 - $37.02

This 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

We anticipate the application window for this opening will close on: 07/15/2024

We are an equal opportunity and affirmative action employer. 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.