Senior Eligibility Consultant, CVS Health

CVS Health

Location:
United States, East Lansing

Category:
Customer Service

Contract Type:
Employment contract

Salary:

18.50 - 38.82 USD / Hour

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Job Description:

As a Senior Eligibility Consultant at CVS Health, you will process accurate and timely policy and eligibility data, collaborate with partners, respond to enrollment issues, design training, mentor junior team members, and resolve complex problems. This role involves delivering consulting services, managing workflows, and supporting data discrepancies and reporting alternatives. Strong communication and leadership skills are expected.

Job Responsibility:

Process accurate and timely policy and eligibility data utilizing administration systems for claim payment purposes and product production
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
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
demonstrated proficiency in processing accurate and timely policy and eligibility data
ability to understand and meet intent/end state with minimal guidance
high school diploma or GED

Nice to have:

Ability to be in the East Lansing, MI or Plymouth, MN offices 3 days per week
coaches and mentors others
ability to manage multiple tasks and shifting priorities
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 for wellness screenings, tobacco cessation, and weight management programs
confidential counseling and financial coaching
benefit solutions including 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