Electronic Eligibility Consultant

Job DescriptionEligibility Consultant is the face of Aetna enrollment functions specific to customer facing interactions with clients and vendors demanding high levels of responsiveness. Responsible and accountable for end-to-end processes associated with enrollment, eligibility and ID card data management inclusive of ongoing maintenance after initial onboarding. Identifies and addresses barriers impacting access to care. Completes manual, complex activity associated with new business/account implementations.Coordinates electronic transfer of eligibility data and maintain enrollment databases.-Map files and data specifications based the customer's product and plan selection.-Under general supervision, verifies enrollment status, makes changes to member/client records, and addresses a variety of enrollment questions or concerns.Required QualificationsCustomer service experience 1- 2 yearsPrior enrollment systems experience preferredEffective organizational skills and ability to manage multiple tasksEffective communication skills, both verbal and writtenStrong Microsoft Office Suite skillsCOVID 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 QualificationsDetail oriented; strong ability to identify, analyze and solve complex service defects, understands the impact eligibility has on downstream applications and functions. Demonstrates attention to detail and the ability to manage multiple competing priorities. Ability to work with autonomy. Attention to detail and accuracy.EducationAssociate's degree or High School degree (GED) with equivalent work experienceBusiness 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: 2026-05-02