Renewals Specialist

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. Position Summary Places a high priority on teamwork, looking beyond the first right answer when assisting others and performing group research. Contributes to the success of the team and individual team members by sharing knowledge, information, experience, skill, and creative ideas within and across teams; build relationships, give and seek input from others, cross‑trains to other departments, ability to assist others in complex builds, quality reports and projects to achieve goals. Is an un‑official leader on the team, aware that actions, attitude, and communications reflect upon not only self but the team as well. Solicits and assesses internal and external customer feedback to drive continuous quality improvement on the renewal process (ie. System tools, resources, etc.). Provides 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. Advanced ability to utilize Meritain’s proprietary system for analytical coding of detailed customized plans rather than standard offerings. Develops and executes implementation strategy consistent with client expectations; ensures strategy is administered in accordance with all performance guarantee arrangements. Consults and advises internal stakeholders on complex benefit administration, advising on options to minimize manual processing and disruption for the clients. Reviews benefit provisions to ensure compliance with state and federal mandates. Evaluation process may also include assessment of summary plan descriptions and other related documents prepared internally or externally by clients. Uses business knowledge and experience to make plan design and processing recommendations when working with clients. Collaborates on review, analysis, and development of recommendations for the design of complex account and benefit structures based on customers’ objectives and Meritain’s system. Executes system setup and mapping of client‑level benefits to align with industry coding (ICD10, Place of Service, Healthcare Reform, etc.), similar to entry‑level IT programming. Required Qualifications Minimum 1 year experience in Meritain Plan Build. 1+ years experienced with various data systems (DOS systems a plus). 1+ years medical terminology knowledge. If local to Plymouth, MN, Lansing, MI or Amherst, NY – Hybrid (3 days onsite (Tuesday‑Thursday) and 2 days remote). Preferred Qualifications 3+ years’ experience working with healthcare (Quality, Claims, and or Plan Build preferred). Ability to research and look beyond the first right answer to find the root of a concern. Be highly organized and able to quickly prioritize multiple assignments with high quality results. Must have strong communication skills with the ability to express complex concepts in a clear and concise manner. High attention to detail and accuracy while focusing on overall project deliverables. Ability to remain flexible yet focused during stressful situations. Analytical and problem‑solving skills. Education High School Diploma or GED. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 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. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments ( Equal Opportunities CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr