Senior Analyst - Claims Business Analysis

CVS Health; Phoenix (AZ); Remote; USD 47,000 - 102,000; Full time

Benefits offered by this job

Bonus eligibility

Comprehensive benefits

Hybrid work policy

Job summary

CVS Health is seeking a data-oriented professional to design, test and enhance information products for internal and external customers. You will manipulate large datasets, ensure data quality and provide actionable insights to improve care delivery.

The role requires experience with claims data, Excel proficiency and QNXT, plus strong communication skills. A hybrid option is available if located near Phoenix, AZ, or remote work may be possible.

Qualifications

• 6+ months experience reading and understanding claims.
• 6+ months of intermediate to advanced Excel.
• 6+ months QNXT experience.
• Excellent verbal and written communication skills.
• MS Office (Word, Access DB, InfoPath).
• Extensive experience with databases and data interpretation.

Responsibilities

• Provides consultation on design, testing and enhancement of information products for customers.
• Researches, manipulates and prepares complex data to document program activities and reports results.
• Oversees data quality and provides feedback to improve service delivery and design efforts.
• Develops consultative relationships with internal/external customers.
• Lead or act as a business technical expert in planning, development and validation of test plans and strategies.
• Translates complex data into clear information and recommendations.

Skills

Reading claims

Excel

QNXT

Communication

MS Office

Databases

Healthcare background

Education

Bachelor's degree

Tools

MS SQL

Remedy

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

• Provides consultation on the design, testing and enhancement of information product including technical assistance and product development support to external and internal customers.
• Researches, manipulates and prepares complex data to document program activities and reports on its results.
• Provides oversight to data quality and provides feedback to various areas in order to improve service delivery and enhancement to design efforts.
• Develops a consultative relationship with internal/external customers.

QNXT is REQUIRED

Excel is REQUIRED

• May lead or act as a business technical expert with the planning, development and validation of master or detail test plans and strategies.
• Performs ongoing research, and support tasks for existing systems.
• Leads or acts as a business technical expert in the design of new applications or enhancements including integration of solutions.
• Provides Leadership/Coaching/Mentoring; may be a mentor to others.
• Directs the implementation of program specific information through education, technology, organizational methods and procedures.
• Influences enhancements to business processes and system infrastructure to improve data quality availability and access.
• Manages customer contact and participates in internal and external health industry development efforts (e.g., performance measurements).
• Analyzes complex data for trends, highlights in-depth interpretations and provides in-depth root cause analysis.
• Consults with client on a regular basis to ensure progress is in line with customer’s expectations and to obtain additional information as needed.
• Translates complex data into constructive data and information and makes recommendations.
• Defines, identifies, develops and implements information products to support strategic business and operational planning.
• Illustrates complex information in a clear concise manner.
• Develops and conducts presentations and consultations to existing and prospective customers and internal business areas.
• Provides workgroup support on projects.
• Educates customer on the value, use and interpretation of information product.
• Influences changes/enhancements to business processes, policies, and system infrastructure to improve information quality, availability and access.
• Evaluates available software and data to deliver better business solutions.
• This position is open to fully remote candidates. If located in Phoenix, AZ, you may be expected to be hybrid.

Required Qualifications

• 6+ Months Working experience reading and understanding claims.
• Working knowledge of reading and reviewing claim and coding types.
• 6+ Months of intermediate to advanced level knowledge of Excel (ability to manipulate large lines of data, work with formulas etc.)
• 6+ Months QNXT.
• Excellent verbal and written communication skills.
• MS Office (Word, Access DB and Info Path etc.).
• Extensive experience with databases as well interpretation and manipulation of related data.
• Healthcare background.

Preferred Qualifications

• MS SQL experience is a plus.
• Remedy (Ticket Tracking) experience is a plus.
• 3-5+ years of data interpretation and analysis experience.
• Bachelor's degree preferred.
• We support a hybrid work environment. If selected and you live near a suitable work location, you may be expected to comply with the hybrid work policy. Under the policy, all hires for in-scope populations should be placed into a hybrid or office-based location, working onsite three days a week.
• Aetna Service Operations office/hub locations will be discussed with the selected candidate.

Education

• Bachelor's degree, technical certification or equivalent work experience.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

$46,988.00 - $102,000.00

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.

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.

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.

We anticipate the application window for this opening will close on: 11/18/2026

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