CVS Health Remote Grievance Analyst (Call Reviewer)

Work Based At Home; Hyde Park Township (IL); Remote; USD 43,000 - 86,000; Full time

Job summary

An established industry player is seeking a dedicated Grievance Analyst to join their dynamic team. In this role, you will play a crucial part in enhancing the accuracy of grievances by analyzing customer interactions and collaborating with various operational teams. Your ability to navigate Microsoft Office tools and apply strong analytical skills will be essential in identifying trends and recommending innovative solutions. This position offers a unique opportunity to make a significant impact in the healthcare sector, ensuring that customer grievances are handled with care and precision. If you are detail-oriented and thrive in a collaborative environment, this role is perfect for you.

Qualifications

• 2 years of experience in customer service roles with complex databases.
• Detail-oriented with strong analytical skills and flexibility to adapt.

Responsibilities

• Analyze grievances and improve accuracy of documentation.
• Collaborate with Customer Care to drive improvements in grievance filings.

Skills

Microsoft Excel

Microsoft Word

Analytical Skills

Customer Service

Education

High School Diploma or equivalent GED

Tools

Microsoft Office

Job description

CVS Health Remote Grievance Analyst (Call Reviewer)

February 7, 2025

Description

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

CVS Health has an exciting new opportunity within the Grievances team in Scottsdale, AZ. As a Grievance Analyst, you will be responsible for partnering with Customer Care and Care Quality to improve the accuracy of grievances filed. The role will include listening to member inbound Care calls to determine whether a grievance should have been filed and evaluating the accuracy of documentation within the grievance. Identifying trends with Customer Care sites and representatives and working with internal partners to drive improvement in grievance filings will be a critical part of this position. The ideal candidate will also recommend innovative solutions to improve the operational performance of Care as it relates to grievances and must be comfortable working with Care partners to implement improvements. Lastly, this position will also include providing support to various operational teams within the Grievance department, as needed. This may include working grievance cases, making member outreach and supporting grievance quality.

To be successful in this role you will need to be proficient in navigating Microsoft Word and Excel, detail-oriented along with having strong analytical skills. A successful Analyst is receptive to constructive feedback and flexible in adapting to change while effective in planning, prioritizing, and organizing their time and workload. This role also requires the ability to work independently to accomplish the overall goal of reducing inappropriate/inaccurate grievance filings.

Required Qualifications

- 2 years of experience working within a customer service role on several computer applications and complex databases for research, including Microsoft Office products (Excel, Word, and Outlook).

Preferred Qualifications

-Previous experience within Pharmacy Benefit Management (PBM) or pharmaceutical related industry.

-Previous Med D grievance experience.

Education

High School Diploma or equivalent GED

Pay Range

The typical pay range for this role is:

$43,888.00 - $85,068.00

This pay range represents the base hourly rate or base annual full-time 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 short-term incentive program in addition to the base pay range listed above.