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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.

A Brief Overview

**Schedule:** _Monday-Friday 8:00am-5:00pm, full telephonic role_

Coordinates member outreach to ensure effective use of health plan benefits, ensure member receipt of important clinical services, and to improve member health outcomes within the Medicaid or Medicare population. Responds to member inquiries in person, via telephone, and in writing. Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory and contractual requirements including outreach to members who are noncompliant in the designated outreach services. Supports effective medical record capture for HEDIS medical record review and abstraction of supplemental data.

What you will do

+ Assists in the development and standardization of outreach documentation and manages the data flow process to complete necessary documentation.

+ Reports analytical findings, provider chart requests, and recommendations to senior leaders.

+ Develops and maintains member incentive programs to support outreach initiatives.

+ Develops educational outreach materials including incentive documents, call scripts, event flyers, and social media texts.

+ Maintains incentive database to track member compliance.

+ Documents complaints and grievances from members and refers them to the appropriate department for timely resolution.

+ Documents member participation in outreach activities in accordance with abstraction and audit standards.

+ Identifies opportunities to partner with community organizations on special events and presentations to heighten awareness locally.

Requirements:

+ Recent and related experience working with HEDIS criteria.

+ Experience with Microsoft Office products (Word, Excel, Project, PowerPoint, Outlook).

+ 0-2 years work experience

+ Bilingual (Spanish/English preferred)

+ Private space to make calls

+ High speed internet

Preferred:

+ Call center experience

+ Experience working in healthcare field, specifically Medicaid population

Education

+ High School Diploma or GED Required, Bachelor's degree preferred.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$21.10 - $40.90

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: 06/27/2025

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.