Full Time

Data and Analytics Consultant – CVS Remote Jobs

Posted 1 year ago
$19 - $35 per hour

Job Description

Job Type: Data and Analytics Consultant from home
Location: Florida work from home
Company: CVS Health


We have an exciting opportunity for a qualified individual to use and develop our company’s core competencies while contributing to the success of our team and organization on the Aetna Commercial Pharmacy Eligibility team. This position entails conducting research, problem solving, and data entry correction to ensure that the pharmacy adjudication system’s eligibility data matches the Aetna enrollment applications data, which serves as the source of truth. The job entails managing shared mailboxes and work queues, resolving issues from various departments within the company, researching and resolving errors from various reports, reconciling eligibility between systems, file tracking and monitoring, and collaborating with various internal and external departments to create efficient resolutions to issues. Working independently as well as collaboratively with the rest of the team is critical to the success of this role.

Pay Scale

The typical salary range for this position is: Maximum: 34.60 Minimum: 18.50

Please keep in mind that this range represents the average pay for all positions in the job grade in which this position is located. The actual salary offer will consider a variety of factors, including location.


Qualifications Required

  • Using various tools and resources, research and resolve Pharmacy Group Eligibility inquiries in an accurate and timely manner.
  • Knowledge of Aetna member source systems and CVS claim adjudication systems, such as RxClaim and PeopleSafe, is required.
  • Clear and concise communication with internal partners such as customer service representatives, enrollment consultants, plan coordination consultants, plan sponsor liaisons, account managers, internal and external auditors.
  • In the appropriate system, update member data to reflect correct demographic and eligibility information.
  • Assure that daily eligibility files are successfully transferred between the Health Plan and the Pharmacy Benefit Manager.
  • Monitor and analyze daily files, errors, and suspended records.
  • Use tools and applications wisely.
  • Follow all aspects of job responsibilities according to detailed work instructions.
  • Create detailed work instructions for new or changed procedures as needed.
  • Ability to effectively prioritize multiple assignments in order to meet deadlines and maintain quality standards
  • Concentrate on problem-solving and comprehensive resolution of complex issues.
  • Early detection of negative member impact and the ability to escalate issues/trends to the appropriate level through clear communication with examples of the issue/trend
  • Identify and report on emerging trends or issues
  • Be willing to change and enthusiastic about new technology/processes.
  • Experience with RxClaim
  • Experience with PeopleSafe
  • Understanding of the Aetna enrollment system and processes (MEA)

Qualifications Preferred

  • Attention to detail
  • Superior time management abilities
  • Knowledge of data research and analysis
  • Outstanding verbal and written communication abilities
  • Knowledge of Microsoft Office products is required (Word, Excel, MS Access, PowerPoint, Outlook, Project)
  • Experience in the health-care industry
  • Experience with Microsoft Excel, including some knowledge of VLookup tables or Pivot Tables

Education: Diploma from a High School