CVS Health · 1 day ago
Senior Analyst Eligibility Operations
St Paul, MN
Full-time
Onsite
Mid, Senior Level
$47K/yr - $122K/yr
3+ years expCVS Health is the nation’s leading health solutions company, dedicated to transforming health care. In this role, you will oversee eligibility protocols, analyze data for compliance, and lead enhancements to processes that ensure operational efficiency within the department.
Health CareMedicalPharmaceuticalRetailSales
Responsibilities
Oversee and ensure the accuracy and compliance of eligibility protocols and standards for department processes
Analyze data and conduct verification checks to ensure the accuracy and completeness of all documentation
Create tools, gather data, and conduct analysis in the development of processes to define and measure across the department and multifunctional areas
Lead and assist with new products and services impacting the department
Identify and implement enhancements to processes and systems resulting in operational efficiencies and improvements
Ensure full compliance with relevant regulations, contractual obligations, and internal policies when assessing eligibility data and department processes
Evaluate complex or high visibility cases, identify risk and recommend appropriate measures to manage risk
Collaborate with other departments to address inquiries, clarify eligibility requirements, enhance processes, and resolve concerns
Solve complex problems, take a new perspective on existing solutions, research and respond to eligibility and other enrollment related issues
Identify opportunities to streamline and enhance the eligibility determination process, making key recommendations to management for review
Generate reports and analyze eligibility data to identify trends, patterns, and insights
Develop training materials and conduct training sessions for employees or stakeholders involved in or connected with the eligibility process
Manage assigned projects and ensure project plans and work tasks are in alignment with overall department and organizational goals; manage multiple tasks and shifting priorities
Operate independently and take initiative, anticipate and prevent problems and roadblocks before they occur, provide accurate and timely results
Qualification
Required
3-4 years of operational experience within Eligibility or Healthcare Benefit Administration
Ability to manage high work volume and oversee a variety of incoming workflows, manage multiple tasks and shifting priorities
Provides accurate and timely results, delegates and follows up as needed
Excellent written and verbal communication skills which demonstrate the ability to interact courteously, effectively, and succinctly with a diverse range of stakeholders across business units with both internal and external customers; skills include listening and comprehension, constructive feedback, spelling, grammar, proofreading, and telephone communication
Demonstrated ability to creatively solve problems and create improvements
Bachelor Degree or High School diploma/GED and equivalent work experience
Preferred
Possess sound knowledge of Meritain Operational processes
Experienced with analytic tools/languages such as SalesForce, Tableau, Access, etc. to analyze large data sets from multiple data sources
Ability to successfully interact with members across business units and with external clients
Ability to communicate effectively and succinctly with a diverse range of stakeholders, both verbally and on paper, and with all levels of an organization
Benefits
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.
Company
CVS Health
CVS Health is a health solutions company that provides an integrated healthcare services to its members.
10001+ employees
H1B Sponsorship
CVS Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2022 (1)
Funding
Current Stage
Public CompanyTotal Funding
$4BKey Investors
Michigan Economic Development CorporationStarboard Value
2025-08-15Post Ipo Debt· $4B
2025-07-17Grant· $1.5M
2019-11-25Post Ipo Equity
Leadership Team
David Joyner
President and Chief Executive Officer, CVS Health
Chandra McMahon
SVP & CISO
Recent News
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