Senior Eligibility Consultant, CVS Health

CVS Health

Location:
United States, East Lansing ▼
Plymouth

Category:
Customer Service

Contract Type:
Employment contract

Salary:

18.50 - 38.82 USD / Hour

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Job Description:

As the nation’s leading health solutions company, CVS Health is building a world of health around every consumer, reaching millions of Americans through its local presence, digital channels, and over 300,000 dedicated colleagues. The Senior Eligibility Consultant processes eligibility data, collaborates with business partners, mentors team members, and delivers consulting services while supporting enterprise goals and initiatives.

Job Responsibility:

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

Requirements:

1-2 years of experience as an Eligibility Consultant, including a demonstrated proficiency in processing accurate and timely policy and eligibility data, ensuring services and products meet the plan sponsor needs, as well as an ability to understand and meet intent/end state with minimal guidance
High school diploma or GED

Nice to have:

Coaches and mentors others
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
Ability to manage high work volume and oversee a variety of incoming workflows
Drafting process documents
Strong background in communication

What we offer:

Affordable medical plan options
401(k) plan including matching company contributions
employee stock purchase plan
No-cost programs 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 29, 2025

Expiration:
May 09, 2025

Employment Type:

Fulltime

Work Type:

Hybrid work

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Senior Eligibility Consultant