Grievance Analyst - Senior Case Reviewer

5 days ago

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CVS Health

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Retail • Pharmacy Benefits Management • Health Insurance • Health Care • Pharmacy

10,000+

Description

• Ensures grievance resolutions meet member concerns and CMS guidelines. • Interacts with clients and internal partners while mentoring caseworkers. • Performs quality reviews of grievance resolution letters. • Identifies quality issues and develops improvement plans with staff. • Supports audits and delivers interdepartmental training.

Requirements

• 2 plus years of customer service experience. • Experience with multiple computer applications and complex databases. • Advanced knowledge of grievance processes. • Bachelor’s Degree preferred.

Benefits

• Full range of medical, dental, and vision benefits. • 401(k) retirement savings plan. • Employee Stock Purchase Plan. • Fully-paid term life insurance plan. • Short-term and long-term disability benefits. • Well-being programs, education assistance, and free development courses. • CVS store discount and discount programs with partners. • Paid Time Off (PTO) and paid holidays.