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
Designs enterprise-wide and/or cross-functional solutions to address business problems. This work results in initiatives that significantly impact organizational strategy, enabling the organization to be competitive in the marketplace and effectively serve its customers. Partners with business owners to optimize the achievement of strategic business objectives, to include profitable growth and improved organizational effectiveness.
What you will do
Advises management through strategic business consultation to support the organization's goals and objectives.
Develops standard procedures related to researching, collecting, analyzing, and compiling data and information for business consulting department reports.
Develops and implements processes for auditing files, reports, and financial records ensuring compliance with relevant laws and regulations.
Communicates with top management to lead individuals to develop a high degree of customer service by fielding internal and external inquiries, finding resolutions, or redirecting as appropriate.
Communicates strategically internally and externally with clients and senior management regarding the organization's goals and objectives.
Counsels the internal and external department point of contact ensuring concise communication with employees, stakeholders, and members of the senior management.
Advises management regarding current business trends and best practices preparing analysis for senior management, stakeholders, and clients.
Controls all systems for performance appraisals within the business consulting department ensuring compliance and continuous improvement.
Evaluates performance through regular, timely feedback to ensure delivery of exceptional services and engagement, motivation, and team development.
Required Qualifications
10+ years work experience in Healthcare Insurance Operations
Mastery of problem solving and decision making skills
Mastery of collaboration and teamwork
Mastery of execution and delivery (planning, delivering, and supporting) skills
Strong SQL Development Skills, Report Development Skills in Power BI and Tableau
Ability to bridge communication gaps between business and IT partners.
Preferred Qualifications
WEDI X12/837I/837P EDI Gateway Processing, Editing and Mapping
Clean Claim Edits
Medicaid Risk Adjustment Strategy
Process Flow and Project Management
Education
4 year degree or equivalent business experience
Pay Range
The typical pay range for this role is:
$100,000.00 - $231,540.00
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. This position also includes an award target in the company's equity award program.
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.
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: 05/30/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
CVS Health offers a world of promising job opportunities across a diverse range of careers in everything from corporate and pharmacy roles to retails positions. No matter where you work at CVS Health, your unique skills, talents and abilities are welcome and valued. We recognize and reward greatness and want our employees to know their work is making a difference in the lives of millions. Join us today. Together we can continue making innovative, high-quality health and pharmacy services safe, affordable and accessible – for all.