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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

+ 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.

+ 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. Advises on options to minimize manual processing and disruption for the clients.

+ Uses business knowledge and experience to make plan design and processing recommendations when working with 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.

+ 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 (ICD 10, place of service, healthcare reform, etc.), similar to entry-level IT programming.

+ Solicits and assesses internal and external customer feedback to drive continuous quality improvement on the renewal process (i.e. system tools, resources, etc.)

+ Demonstrates Salesforce proficiency and understanding for cross-functional communication and enables executive-level status reporting.

Required Qualifications

+ 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.

Preferred Qualifications

+ 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.

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.

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 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 (https://learn.bswift.com/cvshealth-mainland) .

We anticipate the application window for this opening will close on: 11/11/2026

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

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.

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