Healthcare Encounter Senior Analyst

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

Job summary

CVS Health is seeking a Healthcare Encounter Analyst - Senior for claim reconciliation within the State Medicaid Encounters department. The role focuses on researching, analyzing and correcting Medicaid encounters related to Pharmacy-generated data.

You will develop metrics for clients using SAS and AS400-based processes, communicate findings to non-technical stakeholders, and participate in regular client meetings to strengthen partnerships. Strong data analysis and Excel skills are essential.

Qualifications

• 1+ years of professional work experience with data analysis.
• 2+ years of experience using Excel in a professional or academic setting.

Responsibilities

• Research, analyze and correct Medicaid encounters.
• Maintain client relationships and provide recurring metric reports.
• Communicate technical information clearly during client meetings and calls.

Skills

Data analysis

Excel

Communication skills

Problem solving

Education

High school diploma/GED

Bachelor's degree preferred

Tools

SAS

AS400

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

As a Healthcare Encounter Analyst - Senior for claim reconciliation in the State Medicaid Encounters department, you will work exclusively with Pharmacy generated Medicaid encounters. You will be responsible for researching, analyzing and correcting previously submitted, rejected, Medicaid encounters. A self starter with a natural curiosity and a high attention to detail would be well suited for this role, as many potential issues and creative solutions, to those issues, have not been identified yet. This research includes, but is not limited to, examining setups/configurations as well as comparing text files and their contents to identify trends or issues with the integrity of the data within those files. Many innovative solutions are driven from this research and curiosity. You will also be responsible for serving a select group of clients. You will be responsible for maintaining, and in some cases developing, a relationship with key parties on the client side. Part of developing/maintaining a great working relationship with each client will include providing recurring metric reports to keep the client up to date. For the most part, these metrics are produced from SAS, and a proprietary version of AS400. Experience with either of these systems or prior exposure to the PBM or Medicaid industry would be advantageous. The ability to think critically and multitask is very valuable in this role. Additionally, you will be an integral part of recurring client meetings. You must be comfortable and adept with clearly communicating technical information (verbal and written) to non technical people and leading conference calls, when needed.

As part of our CVS Health team, you will be empowered to make decisions and think outside of the box, as we truly value innovation. Our team has expanded rapidly and will provide room for growth in the future. This is an excellent opportunity to be part of a multi-functional team which treats each other like family.

Required Qualifications

• 1+ years of professional work experience with data analysis.
• 2+ years of experience using Excel in a professional or academic setting.

Preferred Qualifications

• 3+ years of professional work experience, preferably in a related field such as data analysis.
• Previous Medicaid Encounter experience and/or PBM experience
• 3+ years experience with Excel
• Must have strong problem solving skills with the ability to work independently
• Great communication skills, as the position will involve communicating with clients

Education

• High school diploma/GED required. Bachelor's degree preferred.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$46,988.00 - $122,400.00

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/28/2026

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