Associate Plan Builder, CVS Health

CVS Health

Location:
United States

Category:
Customer Service

Contract Type:
Not provided

Salary:

43888.00 - 93574.00 USD / Year

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Job offer has expired

Job Description:

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.

Job Responsibility:

Provide plan benefit review, interpretation and systematic setup essential to the processing of our claims adjudication system
Participate and engage in discussion with Clients related to benefit interpretation
Advising on State and Federal Mandates as well as system capabilities
Facilitate client facing review of plan setup walking through all benefits to assure alignment of benefit interpretation
Consult and advise internal stakeholders on complex benefit administration
Reviews benefit provisions to ensure compliance with state and federal mandates
Uses business knowledge and experience to make plan design and processing recommendations when working with Clients
Evaluates impact of client requested exceptions and develops reasonable alternatives to satisfy client’s needs while minimizing impact on Meritain’s system and operations
Collaborates on review, analysis and development of recommendations for the design of complex account and benefit structures based on customers’ objectives and Meritain’s system
Executes system setup and mapping of client level benefits to align with industry coding (ICD 10, Place of service, Healthcare Reform, etc.)
Demonstrates Salesforce proficiency and understanding for cross functional communication and executive level status reporting

Requirements:

Healthcare industry experience (Customer Service, Claims, and or Plan Build preferred)
Experienced with various data systems (DOS systems a plus)
Medical Terminology
Be highly organized and able to quickly prioritize multiple assignments with high quality results
Must have strong communication skills with the ability to express complex concepts in a clear and concise manner
High attention to detail and accuracy while focusing on overall project deliverables
Ability to remain flexible yet focused during stressful situations
Analytical and problem solving skills

Nice to have:

5+ years’ experience working with Healthcare
Salesforce
Ability to research and look beyond the first right answer to find the root of a concern

What we offer:

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
June 05, 2025

Expiration:
June 16, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Associate Plan Builder