Client Operations - Analyst

CVS Health

2d

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. As a Specialty Benefits Analyst, you are responsible for analyzing client requests and performing the necessary specialty benefits coding and quality assurance activities. You’ll work alongside other benefit coders, testers, and quality assurance representatives, as well as our Account, Clinical Requirement Advisors, and implementation management teams to deliver high quality support to our clients. Attention to details is important for this role, as you’re coding and quality assurance activities will impact clients at CVS Health. This position is responsible for analyzing and evaluating changes for updating RxCLAIM and using Salesforce to work cases from a queue. You will be expected to execute with high level of accuracy, responsiveness, and reliability while performing job functions.

Requirements

• Microsoft Office applications
• 2-3 years of direct work experience with PBM knowledge
• Advanced knowledge of AS400 / RxCLAIM platform, system application, and products
• Advanced SalesForce.com Skill
• Time management, Organizing and prioritizing non-routine tasks
• Verbal and written communication
• Analysis and attention to detail
• Interpersonal and collaborative skills
• Prioritize work effectively and independently
• Experience analyzing and executing clinical and/or non-clinical work requests
• Ability to learn and apply increasingly complex concepts, policies, and procedures
• Flexible in adapting to change
• Customer focused

Nice To Haves

• 1-2 years of related work experience
• Pharmacy Technician license
• Provide peer reviews

Responsibilities

• Follow policies and best practices relating to the job function by analyzing client requests, determine the best operational approach and install adjudication related drug lists in Salesforce and RxClaim/AS400.
• Collaborate regularly with peers to audit, review and verify drug list coding and testing while utilizing various tools.
• Analyze and evaluate changes related to specialty pricing and access
• Meet all turnaround time and performance guarantees with excellent quality.
• Capable of applying logical thinking to identify process improvement opportunities.
• Handle requests in a timely fashion without being asked
• Demonstrates ability to learn and apply increasingly complex concepts, policies, and procedures
• Support team members by providing peer reviews

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed