Membership Operations - Analyst

Job DescriptionThis position will be responsible for managing a book of business and representing the Integrated Accumulations Department for CVS/Caremark when working with the assigned Medical Partners/Vendors. This Consultant, will be accountable for interactions with that the assigned medical partner/vendor. This Consultant will be responsible for overseeing the transactions shared between the Medical Partner and CVS/Caremark.. When there are transaction errors, this Consultant will be responsible for resolving those errors either internally or with the help of the Medical Partner. In resolving the transaction errors, this Consultant will be required to investigate and research the source of the error and correct it by using the Department's standard processes and tools. It may also require the Consultant to partner across work streams with other internal resources to ensure the errors are corrected in a timely and efficient manner. This may include representing Integrated Accumulations on cross-functional work teams to resolve specific client issues.This Consultant will be responsible for meeting operational metrics and providing results for their book of business to the department leadership. Lastly this Consultant will be responsible for implementing service for new clients with existing Medical Partners. This will require the Consultant to work with cross-functional Implementation teams to setup and configure the sharing of transactions within the project plan timeline.A successful candidate will possess broad business acumen, strong relationship building and relationship management skills, tenacity to find root cause in any problem, and strong independent work management skills. Outstanding written and oral communication skills are essential, A successful candidate will need to be confident working independently, or within a team, in a dynamic and highly complex environment.PRIMARY DUTIES AND RESPONSIBILITIES: List the top four or five primary responsibilities of the position in the space provided below, indicating the most important functions first and the approximate percentage of time spent on each.Responsibilities % Time1.Planning, organizing, guiding and tracking all work associated with the assigned book of business, ensuring all metrics for assigned book of business are met. 30%2.Establishing and building effective relationships with the assigned medical partners. 20%3.Ensuring all issues and errors are resolved using the department operating standards and within standard turnaround times. 30%4.Implementing new clients as assigned. 20%Required Qualifications1. 1+ years of related professional work experience, Healthcare or PBM preferred2. At least 1 year of experience managing a collaborative relationship, either with internal or external partners.3. 1 or more years of experience using data to solve problems and/or process issues4. 1 or more years of advanced Microsoft Excel experience.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain 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, religious belief, or other legally recognized reasons that prevents them from being 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 or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications1. Strong attention to details and ability to find root cause of issues.2. Ability to analyze and provide resolution to routine business and process issues.3. Ability to collaborate and partner with teams across the PBM and medical partners to guide resolution to issues and requests.4. Ability to operate effectively in a large, complex, and diverse organization. All5. Skilled in focusing on desired results, determining and prioritizing what is important and urgent, clarifying next steps, and escalating issues effectively to meet deadlines and achieve desired results6. Ability to adhere to the highest ethical standards including honesty, integrity, dedication. 7. Ability to use Microsoft Suite of products including Word, PowerPoint, Excel, SharePoint, Visio, Project, etc. All8. Experience with health care, pharmacy benefit management, integrated accumulations, a plus.All9. Operate in a highly complex, matrix, and fast changing environment. This includes managing a book of business that will not be predictable. All10. Work directly with internal partners at all levels (may include benefits, testing, account management, etc)11. Ability to prioritize work, execute work assignemnents to ensure deadlines are met, and identify when deliverables are at risk of not being met.12. Support and adapt to organizational change when requiredEducationVerifiable High School Diploma Required, Bachelors Degree or Equivalent Work Experience preferred.Business 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