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CVS Health Grievance Analyst (Triage & Assignment) in Phoenix, Arizona

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

CVS Health has an exciting new opportunity within the Delegated Grievances team in Scottsdale, AZ. As a Grievance Analyst, you will be responsible for performing triage and assignment of Medicare Part D grievance cases. As part of case triage, you will perform the initial review of grievances to determine whether or not the case is valid, requires a coverage determination or if access to care outreach is needed, among other things. The triage review performed by the Analyst in this position is critical for ensuring successful CMS and client audit results, as well as member satisfaction. After triage is completed, you will be responsible for assigning the case to a grievance caseworker based on department guidelines. The Analyst will also be responsible for reporting case trends to leadership so they can be addressed with internal partners. Lastly, this position will also include providing support to various operational teams within the Grievance department, as needed. This may include working grievance cases, quality review, reviewing member calls and making member outreach.

To be successful in this role you will need to be proficient in navigating Microsoft Word and Excel, detail-oriented along with having strong research skills. A successful Analyst is receptive to constructive feedback and flexible in adapting to change while effective in planning, prioritizing, and organizing their time and workload to achieve turnaround time requirements. The Analyst must have excellent analytical skills, the ability to multitask and be able to perform triage & assignment quickly, while focusing on quality.Required Qualifications1+ years of experience working within a customer service role on several computer applications, including Microsoft Office products (Excel, Word, and Outlook). Preferred QualificationsPrevious experience within Pharmacy Benefit Management (PBM) or pharmaceutical related industry. EducationBachelor's Degree preferred, not required.

Required Skills & Other Minimum Required Qualifications

  • Organize, prioritize and manage multiple tasks on a regular basis with high level of detail

  • Excellent Oral and Written communication skills and interpersonal skills

  • Customer Service internally and externally

  • Adaption to Change Management

  • Self-motivated with a strong attention to detail

  • Ability to work in a high production, time sensitive environment

  • Able to prioritize and manage multiple tasks

  • Demonstrates resourcefulness in problem-solving

  • Displays confidence in the ability to learn complex material

  • Computer Knowledge including: Microsoft office products, Windows based operations, data entry and clinical systems

Pay Range

The typical pay range for this role is:

$40,600.00 - $83,400.00

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 jobs.CVSHealth.com/benefits

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.