Resolution Analyst

Job DescriptionCVS Health has an exciting new opportunity within the Grievances team in Scottsdale, AZ. As a Resolution Analyst - Med D you will be responsible for researching, resolving, and communicating any issues, questions, or concerns our patients and members have about their coverage and benefits provided through Medicare Part D.You will have the opportunity to work cross functionally with different departments within CVS Health to support the research into these members' issues. Once resolved you will be responsible for outreach to each member with a verbal and/or written response explaining the resolution of the issues.As you support our Med D members, we will support you by offering all the tools and resources you need in a collaborative team-based environment. Our goal is to ensure you can provide top tier service and resolution for our members. We use our own emphasis on quality as well as government mandated turnaround times to ensure we do our job effectively, always focusing on helping people on their path to better order to be successful in this role you will need to be detail-oriented with proficient research skills and demonstrate the ability to analyze data, apply learnings, and construct a resolution in a timely manner. 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 to achieve production goals and turnaround time requirements. Analysts are expected to close grievances cases daily, close 15-20 cases per week (depending on inventory) and close all cases within 25 days of TAT while maintaining the highest quality standards. In this position you will be measured by your ability to use your judgement to execute to reach these department goals. Additional responsibilities of the Resolution Analyst include creatively constructing written formal communication to members, multitasking and working with up to 15 various computer applications and documenting the issue and resolutions in the database, while adhering to the strict turnaround times established by the Center for Medicare and Medicaid Services (CMS).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).COVID RequirementsCVS Health requires its Colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. In some states and roles, you may be required to provide proof of full vaccination before you can begin to actively work. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.If you are unable to be fully vaccinated due to disability, medical condition, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. In some states and roles, you may be required to have an approved reasonable accommodation before you can begin to actively work. If your request for an accommodation is not approved, then your employment may be terminated.Preferred Qualifications- Previous experience within Pharmacy Benefit Management (PBM) or pharmaceutical related industry.Bachelor's Degree of Arts or ScienceEducationVerifiable high school diploma or GEDBusiness OverviewBring your heart to CVS HealthEvery 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2025-11-15