Experienced Grievance Analyst - First Call Resolution Specialist for Medicare Part D Grievances

Bringing Our Heart to Every Moment of Your Health at CVS Health

At CVS Health, we're driven by a singular purpose: to bring our heart to every moment of your health. This guiding principle underpins our commitment to delivering enhanced, human-centric health care in a rapidly evolving world. As part of our team, you'll be empowered to play a vital role in transforming our culture and accelerating our ability to innovate and deliver solutions that make health care more personal, convenient, and affordable.

Job Overview: Grievance Analyst - First Call Resolution

We're seeking a dedicated and detail-oriented Grievance Analyst to join our Delegated Grievances team in Scottsdale, AZ. As a Grievance Analyst, you will be responsible for conducting quality reviews on Medicare Part D grievance First Call Resolution cases to ensure they are resolved according to regulatory requirements and meet the highest expectations for a positive member experience. This role is critical in ensuring successful CMS and client audit results, as well as member satisfaction.

Key Responsibilities

• Perform quality reviews on Medicare Part D grievance First Call Resolution cases to ensure accurate documentation, thorough research, and full resolution.
• Determine if cases meet all requirements for complete and accurate resolution, and forward cases to grievance caseworkers as needed.
• Report error trends to leadership to facilitate corrective actions with internal partners.
• Provide support to various operational teams within the Grievance department, including working grievance cases, reviewing member calls, and supporting grievance triage and assignment.
• Utilize Microsoft Word and Excel to efficiently navigate and analyze complex data.
• Maintain a high level of productivity while ensuring quality and attention to detail.

Essential Qualifications

• 2+ years of experience in a customer service role, with proficiency in multiple computer applications and complex databases, including Microsoft Office products (Excel, Word, and Outlook).
• Strong research skills and attention to detail.
• Excellent analytical skills and ability to multitask.
• Receptiveness to constructive feedback and flexibility in adapting to change.
• Effective planning, prioritizing, and organizing skills to achieve turnaround time requirements.

Preferred Qualifications

• Previous experience in Pharmacy Benefit Management (PBM) or pharmaceutical-related industry.
• Medicare Part D grievance experience.
• Bachelor's degree preferred.

What We Offer

At CVS Health, we offer a comprehensive benefits package and a rewarding work environment that supports your growth and well-being. Our benefits include:

• Competitive salary and bonus structure.
• Full range of medical, dental, and vision benefits.
• 401(k) retirement savings plan and Employee Stock Purchase Plan.
• Fully-paid term life insurance and short-term and long-term disability benefits.
• Numerous well-being programs and education assistance.
• CVS store discount and discount programs with participating partners.
• Paid Time Off (PTO) and paid holidays.

Career Growth and Development

As a Grievance Analyst at CVS Health, you'll have opportunities to grow and develop your skills in a dynamic and supportive environment. Our company culture encourages collaboration, innovation, and continuous learning. You'll be part of a team that is passionate about delivering exceptional health care and making a positive impact on our members' lives.

Our Culture and Values

At CVS Health, we're committed to creating a culture that is inclusive, diverse, and empowering. Our Heart At Work Behaviors guide our interactions and decision-making, ensuring that we're always putting our heart into caring for our colleagues and our communities. We're proud to be a Top Workplace in the area, and we're committed to maintaining a work environment that is collaborative, supportive, and rewarding.

Why Join Us?

If you're a motivated and detail-oriented professional looking for a challenging and rewarding role, we encourage you to apply for this Grievance Analyst position. As part of our team, you'll be part of a dynamic and innovative organization that is shaping the future of health care. With our comprehensive benefits package, opportunities for growth and development, and commitment to creating a positive and inclusive work environment, we offer a compelling proposition for talented professionals looking to make a difference.

Take the Next Step

Are you ready for this challenge? Apply now and let's discuss how you can become a vital part of our success story. We look forward to hearing from you!