Dual Entry 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 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:

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
Reviews benefit provisions to ensure compliance with state and federal mandates
Develops and executes implementation strategy consistent with client expectations
Uses critical thinking and extensive knowledge of Meritain’s system and processes to evaluate 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
Effectively manages implementation and provides direction to fellow team members ensuring success of overall implementation process
Solicits and assesses internal and external customer feedback to enhance continuous quality improvement on the implementation process
Demonstrates Salesforce proficiency and understanding for cross functional communication and executive level status reporting
Reviews coverage files at intervals throughout the first year of implementation to analyze for setup adjustments to align with claim processing reports to achieve higher levels of auto adjudication opportunities

Requirements:

1 year healthcare industry experience with benefits interpretation
Customer Service, Claims, and or Plan Build preferred
Salesforce experience preferred
Detail oriented
Highly organized
Good communication skills

Nice to have:

Customer Service, Claims, and or Plan Build preferred
Salesforce experience preferred
Detail oriented
Highly organized
Good communication skills

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:
April 24, 2025

Expiration:
May 02, 2025

Employment Type:

Fulltime

Work Type:

Hybrid work

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Dual Entry Plan Builder