Health Plan Client Experience Leader

Hispanic Alliance for Career Enhancement; Maine; Hybrid; USD 47,000 - 122,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Job summary

CVS Health is seeking a dedicated health benefits support professional based in the United States. The role focuses on client and member support, handling plan changes, ID cards, reporting, and inbound calls, while coordinating across implementation and external meetings.

The position requires 5+ years in pharmacy/PBM/insurance settings, travel up to 25% of the time, and preferred qualifications include a Certified Pharmacy Technician and Salesforce experience.

Qualifications

• 5+ years of experience in a pharmacy, PBM (Pharmacy Benefit Management), and/or insurance setting.
• Ability to travel up to 25% of time within the continental United States.
• Preferred: Certified Pharmacy Technician.
• Preferred: Bachelor's degree.

Responsibilities

• Perform and support plan changes.
• Perform ID card facilitation.
• Complete any necessary reporting (scheduled, ad-hoc).
• Conduct inbound phone calls.
• Complete any assigned invoices.
• Perform any assigned group terminations.
• Complete documentation requests.
• Serve as a presence throughout the implementation process.
• Facilitate and participate in external-facing meetings.
• Perform overrides as needed.
• Oversee prior authorization and accessibility processes.
• Oversee resolution of claims issues.
• Perform manual eligibility adds and terminations.
• Service warranties as assigned.

Skills

Pharmacy/insurance experience

Travel readiness

Education

High school diploma or GED

Bachelor's degree

Tools

Salesforce

Job description

CVS Health is seeking a dedicated health benefits support professional based in the United States. The role focuses on client and member support, handling plan changes, ID cards, reporting, and inbound calls, while coordinating across implementation and external meetings.

The position requires 5+ years in pharmacy/PBM/insurance settings, travel up to 25% of the time, and preferred qualifications include a Certified Pharmacy Technician and Salesforce experience.