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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

+ Provides plan benefit review, interpretation, and systematic setup essential for online viewing and processing related to customer service, claims, enrollment, billing, and reporting in support of internal and external partners.

+ Ability to utilize Meritain’s proprietary system for analytical coding of detailed customized plans rather than standard offerings.

+ Develops and executes implementation strategy consistent with client expectations; ensures strategy is administered in accordance with all performance guarantee arrangements.

+ Consults and advises internal stakeholders on complex benefit administration. Advises on options to minimize manual processing and disruption for the clients.

+ Uses business knowledge and experience to make plan design and processing recommendations when working with clients.

+ Reviews benefit provisions to ensure compliance with state and federal mandates. Evaluation process may also include assessment of summary plan descriptions and other related documents prepared internally or externally by clients.

+ Collaborates on review, analysis, and development of recommendations for the design of complex account and benefit structures based on customers’ objectives and Meritain’s system.

+ Executes system setup and mapping of client level benefits to align with industry coding (ICD 10, place of service, healthcare reform, etc.), similar to entry level IT programming.

+ Solicits and assesses internal and external customer feedback to drive continuous quality improvement on the renewal process (ie. system tools, resources, etc.).

+ Demonstrates Salesforce proficiency and understanding for cross functional communication and enable executive level status reporting.

Required Qualifications

+ 1-3 years of experience working with healthcare.

+ 1+ year of experience working with medical terminology.

Preferred Qualifications

+ 1-3 years of experience working quality, claims, and/or plan building.

+ 5+ years of experience working with healthcare.

+ Experience working with Salesforce.

+ 1+ year of experience with various data systems, including DOS ( _Disk Operating Systems_ ) or CRMs ( _Customer Relationship Management_ ).

+ Ability to research and look beyond the initial answer to find the root of a concern.

+ Ability to be highly organized and to quickly prioritize multiple assignments with high quality results.

+ Strong communication skills with the ability to express complex concepts in a clear and concise manner.

+ High attention to detail and accuracy while focusing on overall project deliverables

+ Ability to remain flexible yet focused during stressful situations.

+ Analytical and problem-solving skills.

+ Ability to work a hybrid schedule (3 days in office) out of Plymouth, MN, Amherst, NY, or Lansing, MI.

Education

High school diploma or GED.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$43,888.00 - $102,081.00

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: 05/12/2025

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.