Client Benefit Representative II

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 300000 purposedriven 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

As a Client Benefit Representative II you will be responsible for analyzing client requests and performing the necessary benefits coding and quality assurance activities. Youll work alongside team responsible for coding testing and performing quality assurance as well as our implementation Management team to deliver high quality support to our clients. Extreme attention to details is important for this role as your coding and quality assurance activities will impact commercial clients at CVS Health. You will be expected to execute with high level of accuracy responsiveness and reliability while performing job functions


What you will do

Configures benefits programs within the healthcare companys systems or databases.

Follow policies and best practices relating to the job function by analyzing client requests determine the best operational approach and install adjudication related drug lists (eg formulary clinical edits plan coverage etc) in Salesforce and Rxclaim/AS400

Processes member or subscriber enrollments into the benefits programs by entering enrollment data verifying eligibility based on plan requirements and ensuring accurate and timely enrollment for individuals or groups.

Able to meet all turnaround time and performance guarantees with excellent quality
Ability to collaborate regularly with peers to audit review and verify drug list coding and testing while utilizing various tools

Ensures the accuracy and integrity of data related to benefits program setup by reviewing and validating data entries performing data audits and making corrections or updates as needed to maintain accurate and uptodate information.

Organizes documentation and records of benefits program setup activities including plan configurations enrollment data eligibility determinations and any modifications or updates made.

Assists in providing regular timely feedback to ensure delivery of exceptional services and engagement motivation and team development.

Communicates with various internal teams such as benefits administration HR or IT to gather and exchange information related to benefits setup and enrollment

Requirements

• 23 years of direct work experience with PBM knowledge
• Proficient use Microsoft Office applications e.g. Excel Word
• Experience with AS400 / RxCLAIM
• Working knowledge of SalesForce

Preferred Qualifications

• Certified Pharmacy Technician

• Well organized with the ability to prioritize work

  effectively and independently

• Flexible in adapting to change

• Excellent time management skills

• Excellent interpersonal and collaborative skills with the ability to work in a team environment

• Ability to work successfully in a deadlineoriented environment

• Excellent verbal and written communication skills

• Strong analytical skills and attention to detail. Ability to define problem review data establish facts and draw valid conclusions

Education

High School Diploma

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 fulltime 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 shortterm 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.

• Nocost 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 anticipate the application window for this opening will close on: 04/14/2025

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