Grievance Analyst (Call Reviewer)

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position Summary CVS Health has an exciting new opportunity within the Grievances team in Scottsdale, AZ. As a Grievance Analyst, you will be responsible for partnering with Customer Care and Care Quality to improve the accuracy of grievances filed. The role will include listening to member inbound Care calls to determine whether a grievance should have been filed and evaluating the accuracy of documentation within the grievance. Identifying trends with Customer Care sites and representatives and working with internal partners to drive improvement in grievance filings will be a critical part of this position. The ideal candidate will also recommend innovative solutions to improve the operational performance of Care as it relates to grievances and must be comfortable working with Care partners to implement improvements. Lastly, this position will also include providing support to various operational teams within the Grievance department, as needed. This may include working grievance cases, making member outreach and supporting grievance quality. To be successful in this role you will need to be proficient in navigating Microsoft Word and Excel, detail-oriented along with having strong analytical skills. A successful Analyst is receptive to constructive feedback and flexible in adapting to change while effective in planning, prioritizing, and organizing their time and workload. This role also requires the ability to work independently to accomplish the overall goal of reducing inappropriate/inaccurate grievance filings. Required Qualifications - 2 years of experience working within a customer service role on several computer applications and complex databases for research, including Microsoft Office products (Excel, Word, and Outlook). Preferred Qualifications -Previous experience within Pharmacy Benefit Management (PBM) or pharmaceutical related industry. -Previous Med D grievance experience. Education High School Diploma or equivalent GED Pay Range The typical pay range for this role is: $43,888.00 - $85,068.00 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | CVS Health We anticipate the application window for this opening will close on: 02/28/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area. Apply Job!