Representative II Benefits Setup

Job DescriptionAs a Benefits Setup Rep II, you will be part of an extremely talented team within our Client Benefits department at CVS Health. You will be responsible for analyzing client requests and performing the necessary benefits configuration testing and quality validation. You'll work alongside other Benefits Coders, Testers, and Quality Assurance Representatives, as well as our Account Management team to deliver high quality support to our vast number of clients. Extreme attention to details important for this role, as your coding and quality assurance activities will impact not only the commercial clients at CVS Health, but the federal and state programs that we participate in, such as Medicare Part D and Medicaid. This is a fantastic opportunity to start your career in the Pharmacy Benefit Management (PBM) industry, as extensive training will be provided.Required Qualifications2+ years of professional work experience in Claims, Insurance, QA, Testing or high-production environmentCOVID 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 QualificationsPrevious work experience in PBM, Medical Claims, Health Insurance, Pharmacy or Benefits highly preferred. - Proficient use Microsoft Office applications, e.g. Excel, Word - Project Management skills - EducationHigh School Diploma or GED RequiredBusiness 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