Eligibility Analyst

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. Position Summary CVS/Caremark, the Pharmacy Benefit Management (PBM) division of CVS Health, is looking for an Eligibility Analyst to join our Eligibility Administration Department. As an Eligibility Analyst for a Fortune 10 organization, you will impact and support customers in all areas including Commercial, Medicare, Medicaid, & Healthcare Plans. Primary responsibilities of the Eligibility Analyst include: • Acting as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocol for clients • Researching and consulting to improve healthcare data integrity and ensure excellent service delivery • Constantly improving healthcare analytical skills that are needed to perform data analysis • Resolving data enrollment issues on a daily basis • Consulting on healthcare data needs • Having exceptional time management and healthcare client management skills • Continuous development training will be provided in this role to ensure the Eligibility Analyst is able to exceed client expectations in this fast-paced environment Required Qualifications • 1+ year(s) in healthcare data eligibility, insurance, IT, benefits, or data analytics environment with a strong ability to work independently, problem solve, and analyze data in a confidential healthcare environment • 2+ years customer service experience in a fast-paced environment • Strong written and verbal communication skills • Ability to communicate with business clients and stakeholders in a professional manner Preferred Qualifications • 3+ years experience in eligibility or other relevant background • Experience in EDI (Electronic Data Interchange) • Understanding of the PBM industry • Familiarity with RxClaim and/or AS400 • Pharmacy technician or benefits verification experience Education High School Diploma (required); Associate's degree or 2 years of PBM or healthcare experience (preferred) Anticipated Weekly Hours40 Time TypeFull time Pay Range The typical pay range for this role is: $43,888.00 - $93,574.00 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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: • Affordable medical plan options,a401(k) plan(including matching company contributions), and anemployee stock purchase plan. • No-cost programs for all colleaguesincluding wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Benefit solutions that address the different needs and preferences of our colleaguesincluding 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. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 08/20/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.