Sr Eligibility Consultant Ops

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary Employee will manage employer groups. They are responsible for handling all eligibility tasks related to their assigned employer groups in addition to providing mentoring, discussing Medicare enrollment guidelines during internal and external calls and will lead or contribute to special projects.You will accomplish this by:• Administer client needs where you respond, research, and resolve eligibility and other enrollment related discrepancies involving member specific information.• Participate in inter-departmental process reviews and training including special projects• Participate in client meetings (Conference Calls and/or Onsite meetings)• Analyze reports and communicate results to clients as you complete data entry requirements for finalizing new enrollment information as well as for changes and/or terminations.• Reconcile enrollment discrepancies between Aetna and clients/vendors• Participate in developing client action plans by working directly with clients/vendors, sales and other assigned account team members to achieve positive service outcomes• Applies Centers for Medicare & Medicaid Services guidance and Aetna policies associated with technical requirements and account structure in addressing eligibility matters.• Ensures all transactions interface accordingly with downstream systems; tests and validates data files for new or existing clients using system tools and tracks results to avoid potential problems and better address on-going service issues. Required Qualifications Excellent verbal and written communication skillsCandidate must be proficient in MS Excel and WordProblem solving skills Education

High School Diploma or General Equivalent Development (GED)

Pay Range

The typical pay range for this role is:

$18.50 - $35.29

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 05/17/2024

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.