Experienced Grievance Analyst - First Call Resolution Specialist for Medicare Part D Grievances

Bringing Our Heart to Every Moment of Your Health at CVS Health At CVS Health, we're driven by a singular purpose: to bring our heart to every moment of your health. This guiding principle underpins our commitment to delivering enhanced, human-centric health care in a rapidly evolving world. As part of our team, you'll be empowered to play a vital role in transforming our culture and accelerating our ability to innovate and deliver solutions that make health care more personal, convenient, and affordable. Job Overview: Grievance Analyst - First Call Resolution We're seeking a dedicated and detail-oriented Grievance Analyst to join our Delegated Grievances team in Scottsdale, AZ. As a Grievance Analyst, you will be responsible for conducting quality reviews on Medicare Part D grievance First Call Resolution cases to ensure they are resolved according to regulatory requirements and meet the highest expectations for a positive member experience. This role is critical in ensuring successful CMS and client audit results, as well as member satisfaction. Key Responsibilities Perform quality reviews on Medicare Part D grievance First Call Resolution cases to ensure accurate documentation, thorough research, and full resolution. Determine if cases meet all requirements for complete and accurate resolution, and forward cases to grievance caseworkers as needed. Report error trends to leadership to facilitate corrective actions with internal partners. Provide support to various operational teams within the Grievance department, including working grievance cases, reviewing member calls, and supporting grievance triage and assignment. Utilize Microsoft Word and Excel to efficiently navigate and analyze complex data. Maintain a high level of productivity while ensuring quality and attention to detail. Essential Qualifications 2+ years of experience in a customer service role, with proficiency in multiple computer applications and complex databases, including Microsoft Office products (Excel, Word, and Outlook). Strong research skills and attention to detail. Excellent analytical skills and ability to multitask. Receptiveness to constructive feedback and flexibility in adapting to change. Effective planning, prioritizing, and organizing skills to achieve turnaround time requirements. Preferred Qualifications Previous experience in Pharmacy Benefit Management (PBM) or pharmaceutical-related industry. Medicare Part D grievance experience. Bachelor's degree preferred. What We Offer At CVS Health, we offer a comprehensive benefits package and a rewarding work environment that supports your growth and well-being. Our benefits include: Competitive salary and bonus structure. Full range of medical, dental, and vision benefits. 401(k) retirement savings plan and Employee Stock Purchase Plan. Fully-paid term life insurance and short-term and long-term disability benefits. Numerous well-being programs and education assistance. CVS store discount and discount programs with participating partners. Paid Time Off (PTO) and paid holidays. Career Growth and Development As a Grievance Analyst at CVS Health, you'll have opportunities to grow and develop your skills in a dynamic and supportive environment. Our company culture encourages collaboration, innovation, and continuous learning. You'll be part of a team that is passionate about delivering exceptional health care and making a positive impact on our members' lives. Our Culture and Values At CVS Health, we're committed to creating a culture that is inclusive, diverse, and empowering. Our Heart At Work Behaviors guide our interactions and decision-making, ensuring that we're always putting our heart into caring for our colleagues and our communities. We're proud to be a Top Workplace in the area, and we're committed to maintaining a work environment that is collaborative, supportive, and rewarding. Why Join Us? If you're a motivated and detail-oriented professional looking for a challenging and rewarding role, we encourage you to apply for this Grievance Analyst position. As part of our team, you'll be part of a dynamic and innovative organization that is shaping the future of health care. With our comprehensive benefits package, opportunities for growth and development, and commitment to creating a positive and inclusive work environment, we offer a compelling proposition for talented professionals looking to make a difference. Take the Next Step Are you ready for this challenge? Apply now and let's discuss how you can become a vital part of our success story. We look forward to hearing from you! Apply for this job