Our Ability Jobs

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

Are you looking for an exciting opportunity to lead a dynamic team that is a key, strategic part of a Fortune 5 company in one of the fastest growing industry fields and an extremely stable line of business?

This challenging leadership role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/stop loss, data analytics, provider and broker relations, underwriting, eligibility, finance, client management and much more. You will have a unique opportunity to hone your skills as a critical thinker, people leader, problem solver, and highly effective communicator with a meticulous eye for detail and superior organization.

Acting as team lead, you will support and act as important liaison and subject matter expert between our internal and external stakeholders and the stop loss carriers. Managing a team of analysts and coordinators who facilitate stop loss claim filings, you will guide the overall oversight and reconciliation/resolution between the amount requested and the amount reimbursed by the stop loss carrier. All while leading a team of talented specialists in a face-paced, dynamic area.

Required Qualifications

• Minimum of 4 years of experience in healthcare claims processing

• Minimum of 5 year of experience with the suite of Microsoft applications (particularly, Excel)

• Minimum of 4 years of demonstrated people leadership

• Ability to work independently across a matrix team in a fast-paced environment

• Exceptionally strong interpersonal and communication skills (verbal and written)

Preferred Qualifications

• Stop Loss/reinsurance experience

• Exposure to a mainframe IBM AIX or AS/400 environments

• Experience in process design and optimization

Education

• 4 year undergraduate degree or equivalent

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$43,888.00 - $85,068.00

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, 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.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 04/02/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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.