Renewal and Reporting Analyst

CVS Health

About The Position

This position provides plan benefit review, interpretation, and systematic setup, which is essential for online viewing and processing related to customer service, claims, enrollment, billing, and reporting, in support of internal and external partners. The role requires the ability to utilize Meritain’s proprietary system for analytical coding of detailed customized plans, moving beyond standard offerings. The analyst will develop and execute implementation strategies consistent with client expectations, ensuring that these strategies are administered in accordance with all performance guarantee arrangements. They will consult and advise internal stakeholders on complex benefit administration, offering options to minimize manual processing and disruption for clients. Leveraging business knowledge and experience, the analyst will make plan design and processing recommendations when working with clients. The role also involves reviewing benefit provisions to ensure compliance with state and federal mandates, which may include assessing summary plan descriptions and other related documents. Collaboration is key for the review, analysis, and development of recommendations for the design of complex account and benefit structures based on customers’ objectives and Meritain’s system. The analyst will execute system setup and mapping of client-level benefits to align with industry coding (e.g., ICD 10, place of service, healthcare reform), a task similar to entry-level IT programming. Furthermore, the position involves soliciting and assessing internal and external customer feedback to drive continuous quality improvement on the renewal process (e.g., system tools, resources) and demonstrating Salesforce proficiency and understanding for cross-functional communication and executive-level status reporting.

Requirements

2+ years of experience working with healthcare, specifically with quality, renewals, client advocacy, and/or account management, including a demonstrated knowledge of medical terminology.
Ability to work Monday-Friday from 8am-5pm, with the ability to work beyond those core hours during busy seasons.
High school diploma or GED.

Nice To Haves

5+ years of experience working with healthcare, specifically with quality, renewals, client advocacy, and/or account management, including a demonstrated knowledge of medical terminology.
Previous experience with Salesforce.
Previous experience with various data systems, including DOS systems.
Ability to research and look beyond the first right answer to find the root of a concern.
Strong analytical and problem-solving skills.
Ability to remain flexible yet focused during stressful situations.
Strong communication skills, with the ability to express complex concepts in a clear and concise manner.
Excellent organization skills and ability to quickly prioritize multiple assignments with high quality results.
High attention to detail and accuracy, while focusing on overall project deliverables.
Associate’s or Bachelor’s degree.

Responsibilities

Provide 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.
Utilize Meritain’s proprietary system for analytical coding of detailed customized plans, rather than standard offerings.
Develop and execute implementation strategy consistent with client expectations.
Ensure strategy is administered in accordance with all performance guarantee arrangements.
Consult and advise internal stakeholders on complex benefit administration.
Advise on options to minimize manual processing and disruption for the clients.
Use business knowledge and experience to make plan design and processing recommendations when working with clients.
Review benefit provisions to ensure compliance with state and federal mandates.
Evaluate summary plan descriptions and other related documents prepared internally or externally by clients.
Collaborate on review, analysis, and development of recommendations for the design of complex account and benefit structures based on customers’ objectives and Meritain’s system.
Execute 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.
Solicit and assess internal and external customer feedback to drive continuous quality improvement on the renewal process (i.e. system tools, resources, etc.).
Demonstrate Salesforce proficiency and understanding for cross-functional communication and enables executive-level status reporting.