Our Ability Jobs

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

As claim auto adjudication grows in importance as part of our enterprise strategy, the ACAS Auto Adjudication (AA) team is looking for a qualified individual interested in joining our team as a Senior Analyst. The qualified candidate will work with our vendor partner, Rocket Software, to improve AA through Robotic Automation Process (RPA). As a member of this team, you will have a direct impact on Our Common Purpose—particularly Building Trust. We are looking for a highly motivated, quality-oriented candidate who uses their ACAS claim processing and analytical skills to improve AA Rates. This individual can effectively prioritize work, follow critical documentation guidelines and be flexible.

MINIMUM REQUIREMENT: ACAS Medical/Hospital Claim Processing experience

Members of the medical ACAS AA/Rocket Software team: • Act as ACAS Medical/Hospital SMEs by capitalizing on platform and policy expertise • Work with our Business Partners, Medical Policy, our RPA vendor, Rocket, and many others to document requirements for automated processing • Work with our RPA vendor, Rocket, to share the requirements and to have them write code • Analyze edits to provide Business Process Redesign (BPR) opportunities Once on the team, the selected candidate will also have the opportunity to: • Collaborate and build relationships with their teammates as well as many cross-functional partners such as Claim Quality, Claim Rework, Medical Policy & Support, Compliance, Network Management and our Business Partners from National Accounts, Public & Labor and all other Business Segments • Learn to data mine in QMF and/or MS Access to retrieve claims for analysis and enhance their MS Excel skills

Required Qualifications Required work experience: • ACAS Medical/Hospital Claim Processing experience • Ability to adapt to a fast-paced working environment • Strong organizational skills & time management • Daily use of MS Excel • Self-motivated with the ability to embrace change • Strong problem solving and data analysis skills • Project management or equivalent work experience • Frequent collaborator Preferred Qualifications • Please see required skills Education • High School Diploma or G.E.D

Pay Range

The typical pay range for this role is:

$43,700.00 - $107,200.00

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

We anticipate the application window for this opening will close on: 06/26/2024

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.