Grievance and Appeal - Senior Analyst

CVS Health; United States; Remote; USD 46,000 - 113,000; Full time

Job summary

CVS Health is seeking a Grievance and Appeal Specialist to process escalated cases submitted by regulatory bodies. This role requires 2-3 years of experience in health insurance grievances and a high school diploma. Join a leading health solutions company and contribute to transforming healthcare.

Benefits

401(k) plan with company match

Affordable medical plan options

Employee stock purchase plan

No-cost wellness programs

Tuition assistance

Qualifications

• 2-3 years of experience in processing health insurance grievance and appeal cases.
• Preferred: 6+ months of compliance experience.

Responsibilities

• Complete escalated Grievance and Appeal cases.
• Work with state and federal regulatory bodies.

Skills

Health insurance grievance processing

Compliance

Education

High School Diploma or GED

Job description

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven 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
Complete escalated Grievance and Appeal cases submitted by state and federal regulatory bodies.

Required Qualifications

• 2-3 years of must have experience processing health insurance grievance and appeal cases.

Preferred Qualifications

• 6+ months of compliance experience
• Medicare and Medicaid Regulatory experience.

Education

• High School Diploma or GED Required

Anticipated Weekly Hours

40

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven 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
Complete escalated Grievance and Appeal cases submitted by state and federal regulatory bodies.

Required Qualifications

• 2-3 years of must have experience processing health insurance grievance and appeal cases.

Preferred Qualifications

• 6+ months of compliance experience
• Medicare and Medicaid Regulatory experience.

Education

• High School Diploma or GED Required

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$46,988.00 - $112,200.00

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.

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.

• 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.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 06/25/2025

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

About the company

At CVS Health, we share a clear purpose: helping people on their path to better health. Through our health services, plans and community pharmacists, we’re pioneering a bold new approach to total health. Making quality care more affordable, accessible, simple and seamless, to not only help people get well, but help them stay well in body, mind and spirit.

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