Plan Benefit Review Specialist

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 colleagues who care deeply, innovate with purpose, and prioritize safety and quality in everything we do.

Position Summary

The Plan Benefit Review Specialist provides plan benefit review, interpretation, and systematic setup for online viewing and processing, supporting internal and external partners. Key responsibilities include:

• Utilizing Meritain's proprietary system for analytical coding of customized plans
• Developing and executing implementation strategies consistent with client expectations
• Consulting and advising internal stakeholders on complex benefit administration
• Using business knowledge and experience to make plan design and processing recommendations
• Reviewing benefit provisions to ensure compliance with state and federal mandates
• Collaborating on review, analysis, and development of recommendations for complex account and benefit structures
• Executing system setup and mapping of client-level benefits to align with industry coding
• Soliciting and assessing internal and external customer feedback to drive continuous quality improvement

Required Qualifications

• 2+ years of experience working with healthcare, specifically with quality, renewals, client advocacy, and/or account management
• Ability to work Monday-Friday from 8am-5pm, with flexibility to work beyond core hours during busy seasons

Preferred Qualifications

• 5+ years of experience working with healthcare, specifically with quality, renewals, client advocacy, and/or account management
• Previous experience with Salesforce
• Previous experience with various data systems, including DOS systems
• Strong analytical and problem-solving skills
• Excellent organization skills and ability to prioritize multiple assignments with high-quality results

Benefits

This full-time position is eligible for a comprehensive benefits package, including medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources.