Eligibility Data Analyst

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At CVS Health, were building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nations 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

CVS/Caremark, the Pharmacy Benefit Management (PBM) division of CVS Health, is in search of an Eligibility Data Analyst to join our Eligibility Administration Department. As an Eligibility Data Analyst, you will provide strategic leadership for client and vendor eligibility data exchange, acting a liaison between clients, vendors, and DDAT IT (Digital, Data, Analytics & Technology) to shape business requirements and approve file programming specifications. Your expertise will support new client implementation efforts, ensuring accurate and timely loading of eligibility member data while effective coordinating file-related issues or system errors with DDAT IT. Youll oversee eligibility data validation and verification, maintaining system integrity through audits and reconciliation, and lead high-impact customer projects.

Primary responsibilities of an Eligibility Data Analyst

• Provide strategic oversight and direction for client and vendor eligibility data exchange functions and services.

• Act as a key liaison between clients, vendors, and the PSS IT department to shape business requirements for non-standard or customized processes, while championing innovative solutions and approving programming specifications critical for testing non-standard arrangements.

• Drive and manage projects with eligibility impacts, including vendor changes and new client implementations, as well as handling existing client add-on requests.

• Supervise the validation and confirmation of data feeds from clients to maintain system integrity through regular audits and reconciliation; directly engage with third-party vendors for data exchange setups and troubleshooting.

• Serve as a bridge between clients, vendors, and the PSS IT department to define business requirements for non-standard or customized processes; assist in identifying potential solutions and approve programming specifications required for testing any non-standard arrangements.

• Ensure the accurate and timely loading of eligibility data.

• Oversee the validation and verification of data feeds from clients to uphold system integrity through detailed audits and reconciliation; directly engage with third-party vendors to streamline data exchange setups and troubleshoot challenges.

Required Qualifications

• Minimum of 2 years of experience in PBM or Health Plan eligibility with experience in a client-facing role in a fast-paced environment.

• Demonstrated expertise in aligning key PBM concepts and data fields across diverse systems and file formats, including proficiency with EDI 834, to ensure data transfer consistency and accuracy.

• Proven track record of effectively executing, testing, and maintaining critical operational tasks.

• MS Office (Word, Excel, Access DB, Info Path)

Preferred Qualifications

• Experience with using SQL, Excel, Access Database and other technical data skills.

• Self-motivated individual with a keen eye for detail and a knack for solving complex problems.

• Capable of managing multiple competing priorities in a dynamic environment and collaborating effectively within a team setting.

• Excellent communication skills, time and project management, problem solving, analytical skills, and with a demonstrated ability to cultivate productive relationships with both internal and external stakeholders.

Education

• High School Diploma or GED required.

• Bachelors Degree preferred

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

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

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Information :

• Company : CVS Health
• Position : Eligibility Data Analyst
• Location : Remote in Austin, TX
• Country : US

How to Submit an Application:

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