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[Remote] Membership Operations Analyst

Work from home Full-time role Hiring

Note: The job is a remote job and is open to candidates in USA. CVS Health is committed to building a more connected and compassionate health experience. The Membership Operations Analyst will manage a book of business, oversee transactions with medical partners, and resolve transaction errors while meeting operational metrics and implementing services for new clients.

Responsibilities

  • This position will be responsible for managing a book of business and representing the Integrated Accumulations Department for CVS/Caremark when working with the assigned Medical Partners/Vendors
  • This Analyst will be accountable for interactions with that the assigned medical partner/vendor
  • This Analyst will be responsible for overseeing the transactions shared between the Medical Partner and CVS/Caremark
  • When there are transaction errors, this Consultant will be responsible for resolving those errors either internally or with the help of the Medical Partner
  • In resolving the transaction errors, this Analyst will be required to investigate and research the source of the error and correct it by using the Department’s standard processes and tools
  • It may also require the Analyst to partner across work streams with other internal resources to ensure the errors are corrected in a timely and efficient manner
  • This may include representing Integrated Accumulations on cross-functional work teams to resolve specific client issues
  • This Analyst will be responsible for meeting operational metrics and providing results for their book of business to the department leadership
  • Lastly this Analyst will be responsible for implementing service for new clients with existing Medical Partners
  • This will require the Analyst to work with cross-functional Implementation teams to setup and configure the sharing of transactions within the project plan timeline

Skills

  • 1+ years of related professional work experience
  • At least 1 year of experience managing a collaborative relationship, either with internal or external partners
  • 1+ year of experience using data to solve problems and/or process issues
  • 1+ year of advanced Microsoft Excel experience
  • High School Diploma Required
  • Analyze data and processes to identify issues and root causes
  • Support resolution of routine business and operational issues
  • Prioritize tasks, manage deadlines, and escalate risks as needed
  • Collaborate with cross‑functional internal partners
  • Operate effectively in a fast‑paced, matrixed environment
  • Adapt to changing priorities and organizational needs
  • Maintain high standards of integrity, accuracy, and accountability
  • Proficient in Microsoft Office; healthcare or PBM experience a plus
  • Bachelors Degree or Equivalent Work Experience preferred

Benefits

  • Medical, dental, and vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Other resources, based on eligibility

Company Overview

  • CVS Health is a health solutions company that provides an integrated healthcare services to its members. It was founded in 1963, and is headquartered in Woonsocket, Rhode Island, USA, with a workforce of 10001+ employees. Its website is https://www.cvshealth.com/.
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