Healthcare Renewal & Reporting Analyst

CVS Health; New Mexico; Hybrid; USD 47,000 - 122,000; Full time

Job summary

CVS Health is seeking a benefits operations professional to review and interpret plan benefits, set up configurations in Meritain’s system, and support online viewing and processing for clients and internal partners.

The role emphasizes Salesforce proficiency, collaboration with stakeholders, and the ability to map client benefits to ICD-10 and relevant policies, with a 40-hour work week and competitive benefits.

Qualifications

• 2+ years of experience working with healthcare, specifically with quality, renewals, client advocacy, and/or account management, including a demonstrated knowledge of medical terminology.
• Ability to work Monday-Friday from 8am-5pm, with the ability to work beyond those core hours during busy seasons.
• 5+ years of experience working with healthcare, specifically with quality, renewals, client advocacy, and/or account management, including a demonstrated knowledge of medical terminology.
• Previous experience with Salesforce.
• Previous experience with various data systems, including DOS systems.
• Ability to research and look beyond the first right answer to find the root of a concern.
• Strong analytical and problem‑solving skills.
• Ability to remain flexible yet focused during stressful situations.
• Strong communication skills, with the ability to express complex concepts in a clear and concise manner.
• Excellent organization skills and ability to quickly prioritize multiple assignments with high quality results.
• High attention to detail and accuracy, while focusing on overall project deliverables.
• Associate’s or Bachelor’s degree.

Responsibilities

• Provides plan benefit review, interpretation, and systematic setup, essential for online viewing and processing, related to customer service, claims, enrollment, billing, and reporting, in support of internal and external partners.
• Ability to utilize Meritain’s proprietary system for analytical coding of detailed customized plans, rather than standard offerings.
• Develops and executes implementation strategy consistent with client expectations; ensures strategy is administered in accordance with all performance guarantee arrangements.
• Consults and advises internal stakeholders on complex benefit administration. Advises on options to minimize manual processing and disruption for the clients.
• Uses business knowledge and experience to make plan design and processing recommendations when working with clients.
• Reviews benefit provisions to ensure compliance with state and federal mandates. Evaluation process may also include assessment of summary plan descriptions and other related documents prepared internally or externally by clients.
• Collaborates on review, analysis, and development of recommendations for the design of complex account and benefit structures based on customers’ objectives and Meritain’s system.
• Executes system setup and mapping of client level benefits to align with industry coding (ICD 10, place of service, healthcare reform, etc.), similar to entry‑level IT programming.
• Solicits and assesses internal and external customer feedback to drive continuous quality improvement on the renewal process (i.e. system tools, resources, etc.)
• Demonstrates Salesforce proficiency and understanding for cross‑functional communication and enables executive‑level status reporting.

Skills

Healthcare knowledge

Salesforce

Analytical thinking

Problem solving

Communication skills

Education

High school diploma or GED

Associate’s or Bachelor’s degree

Tools

Salesforce

DOS systems

Job description

CVS Health is seeking a benefits operations professional to review and interpret plan benefits, set up configurations in Meritain’s system, and support online viewing and processing for clients and internal partners.

The role emphasizes Salesforce proficiency, collaboration with stakeholders, and the ability to map client benefits to ICD-10 and relevant policies, with a 40-hour work week and competitive benefits.