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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

The Senior Analyst, Financial Operations role performs claims reverse and reprocessing (R&R) to address benefit coding errors, eligibility changes, program features, and client requests. This position focuses on Commercial and Performance Guarantee Clients which have strict turnaround times and financial penalties tied to them. This will require someone with strong time management skills. This reprocessing is a vital step in the Adjustment or Service Warranty process. This entails resolving rejects and QA fails, obtaining multiple levels of approvals, and closing out the cases in a timely manner to issue financial impacts to members, clients, and pharmacies. This activity touches millions of claims a year and has wide organizational impacts.

This role is required to manage an individual queue of multiple projects in a fast-paced, process-driven environment. Attention to detail, excellent communication, and time-management skills are essential. A Senior Consultant will handle complex adjustments and cases tied to clients with strict performance guarantees. At times, this role will be expected to present and explain the work completed to other parties, both internal and external. A senior member of the team would also take on responsibilities outside of their specific queue that benefits the team (macros, training, reporting, documentation, collaboration, etc).

Additional tasks associated with this position include:

-- Extract claim data from RxClaim

-- Run and troubleshoot macros at regular intervals for business-critical workflows

-- Summarize adjustment information and manipulate data into reports that reflect financial impact and details on an adhoc basis

Analysts work closely with multiple internal departments such as Sales, Account Management, IT, Client Audit, Networks, Benefits, and Implementations to manage and coordinate the work.

Required Qualifications

-- Minimum 2 years of healthcare experience

-- Minimum 2 years of utilizing advanced Excel skills

Preferred Qualifications

-- PBM Industry and plan design.

-- RxClaim adjudication or benefits knowledge.

-- PBM or claim adjudication knowledge.

-- Proficiency in IBM AS400.

-- Understanding of SQL or other querying tools.

-- Understanding of data sets, tables/files, queries, joins, and other database concepts.

-- Ability to program using Visual Basic for Applications or other automation tools

-- Strong customer service focus that includes both internal and external customers.

-- Excellent verbal and written communication skills.

Education

--Verifiable Bachelor's degree or equivalent experience required.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$46,988.00 - $112,200.00

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.

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: 08/08/2025

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.