Eligibility Data Analyst, CVS Health

CVS Health

Location:
United States, Work At Home

Category:
Customer Service

Contract Type:
Not provided

Salary:

43888.00 - 85068.00 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:

Provide strategic oversight and direction for client and vendor eligibility data exchange functions and services
Act as a key liaison between clients, vendors, and the PSS IT department to shape business requirements for non-standard or customized processes, while championing innovative solutions and approving programming specifications critical for testing non-standard arrangements
Drive and manage projects with eligibility impacts, including vendor changes and new client implementations, as well as handling existing client add-on requests
Supervise the validation and confirmation of data feeds from clients to maintain system integrity through regular audits and reconciliation
directly engage with third-party vendors for data exchange setups and troubleshooting
Serve as a bridge between clients, vendors, and the PSS IT department to define business requirements for non-standard or customized processes
assist in identifying potential solutions and approve programming specifications required for testing any non-standard arrangements
Ensure the accurate and timely loading of eligibility data
Oversee the validation and verification of data feeds from clients to uphold system integrity through detailed audits and reconciliation
directly engage with third-party vendors to streamline data exchange setups and troubleshoot challenges

Requirements:

Minimum of 2 years of experience in PBM or Health Plan eligibility with experience in a client-facing role in a fast-paced environment
Demonstrated expertise in aligning key PBM concepts and data fields across diverse systems and file formats, including proficiency with EDI 834, to ensure data transfer consistency and accuracy
Proven track record of effectively executing, testing, and maintaining critical operational tasks
MS Office (Word, Excel, Access DB, Info Path)

Nice to have:

Experience with using SQL, Excel, Access Database and other technical data skills
Self-motivated individual with a keen eye for detail and a knack for solving complex problems
Capable of managing multiple competing priorities in a dynamic environment and collaborating effectively within a team setting
Excellent communication skills, time and project management, problem solving, analytical skills, and with a demonstrated ability to cultivate productive relationships with both internal and external stakeholders

What we offer:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility

Additional Information:

Job Posted:
April 24, 2025

Expiration:
May 19, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Eligibility Data Analyst