Senior Eligibility Specialist

CVS Health; Minneapolis (MN); On-site; USD 25,000 - 53,000; Full time

Job summary

CVS Health is seeking a Senior Eligibility Consultant to join the Eligibility team and drive accurate, timely processing of enrollment and eligibility issues. You will mentor newer colleagues and partner with internal teams, clients and vendors to deliver high‑quality outcomes.

In this senior role you will manage a high volume of work across shifting priorities, support transitions for new staff, and help bridge training into production work while maintaining strong attention to detail and

Qualifications

• 2+ years experience in enrollment/eligibility processing.
• Professional email communication with clear documentation and timely updates.
• Ability to manage multiple workflows and shifting priorities.
• Experience supporting internal reporting and meeting deadlines.
• Proven ability to meet turnaround times with accuracy and quality.
• Experience coaching or onboarding others in a production environment.

Responsibilities

• Process policy and eligibility data on time using systems to support claims and plan sponsor service.
• Resolve complex eligibility issues by investigating discrepancies and driving closure.
• Coordinate with internal teams, clients and vendors to remove blockers and achieve outcomes.
• Anticipate issues to prevent rework and delays across workflows.
• Contribute to process improvements for accuracy and efficiency.
• Support reporting and data discrepancy tasks, documenting trade‑offs and options.
• Design and deliver transition support for new hires moving into production.
• Coach junior team members with side‑by‑side support and knowledge sharing.
• Manage multiple tasks with shifting priorities while maintaining quality.
• Operate as a strong team player and work independently when needed.

Skills

Eligibility processing

Email communication

Multitasking

Mentoring

Stakeholder coordination

Education

High School diploma

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

This role is a senior individual contributor on the Eligibility team, responsible for accurate, timely eligibility processing and resolution of complex enrollment and eligibility issues. Senior Eligibility Consultants operate with increasing independence, manage a high volume of work across shifting priorities, and partner with internal teams, clients, and vendors to drive clear, high-quality outcomes. You’ll also support team capability by mentoring newer colleagues and helping bridge formal training into day‑to‑day production work.

In this role as a Senior Eligibility Consultant, you will:

• Process policy and eligibility data accurately and on time using administration systems to support claim payment and plan sponsor service expectations
• Resolve complex eligibility and enrollment issues by investigating discrepancies, identifying root causes, and driving issues to closure
• Partner with internal teams, clients, and vendors to coordinate information, remove blockers, and achieve positive outcomes
• Anticipate potential issues and take action early to prevent rework, delays, or downstream impacts
• Contribute to process improvements that strengthen accuracy, efficiency, and consistency across workflows
• Support reporting and data discrepancy work by helping evaluate options, documenting trade‑offs, and recommending workable paths forward
• Design and deliver transition support for newly hired colleagues as they move from classroom learning into the production environment
• Coach and mentor junior team members through side‑by‑side support, feedback, and knowledge sharing
• Manage multiple tasks and shifting priorities while maintaining quality and attention to detail
• Contribute as a strong team player who can operate independently when needed

Required Qualifications

• 2+ years experience industry knowledge and enrollment/eligibility processing experience
• Demonstrated comfort with professional email communication, including clear documentation, timely updates, and appropriate tone with internal and external partners
• Ability to manage multiple incoming workflows and shifting priorities while staying organized and responsive
• Experience supporting internal reporting requirements, including tracking work status, documenting outcomes, and meeting reporting deadlines
• Proven ability to meet required turnaround times while maintaining strong accuracy and quality standards
• Experience coaching, mentoring, or onboarding others in a production environment

Preferred Qualifications

• Direct experience supporting COBRA and/or Eligibility programs, including familiarity with downstream impacts to claims and member experience
• Experience handling escalated or exception‑based eligibility cases (conflicting inputs, unclear data, complex retroactivity)
• Experience identifying root causes of recurring issues and driving small process improvements that reduce rework
• Experience supporting transitions (new clients, new processes, or system changes) and helping others ramp successfully
• Experience creating or improving job aids, reference guides, or training materials for team use

Education

• High School diploma, G.E.D. or equivalent experience.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

$18.50 - $38.82

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.

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.