Our Ability Jobs

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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

Benefit Analyst will perform analysis of source materials supplied by Health Plans, and document requirements for benefit administration in business application systems.

Position will be responsible for the research and review of QNXT benefit configuration against State, CMS and internal documentation to determine correct benefits structure. Candidate will review and update existing benefit grids and will be responsible for creating grids for new lines of business. Responsibilities also include issue resolution, ongoing system change request review, and periodic audit of the current benefit set up to ensure accuracy. Position will be a key resource and business partner to our Health Plans and CSRA Management for all benefit administration items.

We are looking for a well-rounded individual with skills including:

· Proven track record in meeting project milestones, strong management skills and the ability to work independently to achieve timely results.

· Collaborate with internal and external partners to produce accurate results.

· Independently research Medicaid State, CMS and other internal and external source documentation to determine correct benefit structure and system set up requirements.

· Time management to complete work according to documented service level agreements.

· Ability to interpret State and Health Plan source documentation and understanding of its relation to internal documentation and QNXT output.

Required Qualifications

QNXT knowledge

Strong written and verbal communication skills

Time Management

Comparative analysis

Claim processing and/or claim research resolution.

Preferred Qualifications

Knowledge of medical coding and terminology, certified coder not required.

QuickBase administration.

Microsoft SQL knowledge.

Microsoft Excel knowledge.

Project management experience.

We support a hybrid work environment. If selected and you live near a suitable work location, you may be expected to comply with the hybrid work policy. Under the policy, all hires for in scope populations should be placed into a hybrid or office-based location, working onsite three days a week.

Aetna Service Operations office/hub locations will be discussed with the selected candidate.

Education

Bachelor degree or equivalent professional experience

Pay Range

The typical pay range for this role is:

$60,300.00 - $132,600.00

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.

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 Benefits | CVS Health (https://jobs.cvshealth.com/us/en/benefits)

We anticipate the application window for this opening will close on: 10/20/2024

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.