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CVS Health · 6 days ago

Advanced Eligibility Consultant

St Paul, MN

Full-time

Onsite

Mid, Senior Level

$44K/yr - $102K/yr

3+ years exp

CVS Health is the nation’s leading health solutions company, dedicated to transforming health care. The Advanced Eligibility Consultant role involves managing complex eligibility issues, mentoring junior staff, and optimizing processes to enhance operational excellence.

Health CareMedicalPharmaceuticalRetailSales

Responsibilities

Serve as a pivotal resource for the organization’s most intricate and high-value client portfolios

Manage and resolve multifaceted eligibility issues with minimal oversight

Engage cross-functionally with internal departments, external clients, and broker partners to deliver expert guidance and solutions

Function as the principal escalation point prior to Manager or Director intervention

Responsible for the ongoing development and mentorship of junior staff

Design and implement comprehensive training programs

Orchestrate and align daily operational objectives

Identify and execute process optimization strategies

Leverage subject matter expertise to drive continuous improvement and operational excellence across the eligibility function

Qualification

Eligibility ConsultingData ProcessingProcess ImprovementCoachingMentoringOrganizational SkillsAutonomyTeam Collaboration

Required

3-4 years experience as an Eligibility Consultant, with a proven track record of managing complex eligibility and policy data for high-value plan sponsors

Advanced proficiency in the accurate and timely processing of eligibility data, ensuring alignment with client requirements and organizational standards

Ability to synthesize organizational intent and end-state objectives, operating with a high degree of autonomy to achieve desired outcomes

Exceptional organizational skills, with the capacity to manage multiple concurrent priorities in a dynamic environment

Demonstrated ability to function both independently and as an integral member of a collaborative team

Consistent delivery of precise and timely results, with effective delegation and follow-up as required

Experience in coaching and mentoring junior colleagues, including the design, development, and facilitation of transitional training programs to support the seamless integration of new hires from classroom instruction to full productivity

Proven ability to identify, recommend, and implement process improvements and operational efficiencies

Preferred

Experience in processing policy and eligibility data with a high degree of accuracy and timeliness, ensuring that all services and products consistently align with the specific requirements of plan sponsors

Experience in coaching, mentoring, and developing others within a team or organizational setting

Demonstrated leadership in complex eligibility operations

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.