Eligibility Specialist

Senior Eligibility ConsultantAt 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 SummaryIn this role as a Senior Eligibility Consultant you will:Process accurate and timely policy and eligibility data utilizing administration systems for claim payment purposes and product production ensuring services and products meet plan sponsor needsCollaborate with business partners to understand enterprise initiatives and goalsRespond to eligibility and other enrollment related issuesPartner directly with clients, vendors, internal teams, and/or local claim operation to resolve problems and achieve positive outcomesAnticipate and prevent problems and roadblocks before they occurSolve complex problems and take a new perspective on existing solutionsDesign, develop, and deliver transitional training processes and procedures to smooth the transition for newly hired employees from formalized classroom training to the department's production environment; mentor junior team membersAssist with and/or evaluate recommendations involving eligibility reporting solutions and negotiate with internal/external clientsDeliver consulting services in support of data discrepancies and/or involving reporting alternativesRequired Qualifications2+ years experience as an Eligibility ConsultantProficiency in processing accurate and timely policy and eligibility data, ensuring services and products meet the plan sponsor needsUnderstands intent/end state and operates with minimal guidance to meet that intent/end stateAbility to manage multiple tasks and shifting prioritiesA team player capable of operating independently when neededProvides accurate and timely resultsDelegates and follows up as neededCoaches and mentors othersAbility to manage high work volume and oversee a variety of incoming work flowsPreferred QualificationsIndustry knowledgeEnrollment processing experienceEducationHigh School diploma, G.E.D. or equivalent experienceAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$18.50 - $38.82This 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 peopleWe 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.We anticipate the application window for this opening will close on: 07/03/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.