Rep III, Benefits Setup

Job DescriptionMust live in the Irving, TX area. Will work in office two days, work from home three daysCVS Health is seeking a highly motivated professional individual to engineer efficient test solutions of highest quality at lowest possible cost using modern technology practices. This is a Representative III position within the Testing Center of Excellence (TCoE) department. This individual will support Testing and work with our internal customers along with other job duties as required. This Representative III will need to work on the test strategies for ensuring the accuracy of Benefit and clinical Testing and could be requested to discuss test results with senior leadership across multiple lines of business. This Representative III will work as team Member for Benefit and Clinical Testing team, which will include running queries, Claims and analyzing testing defects either within the TCoE department or with our Internal Customers. This individual will be required to engage internal business partners and leaders as needed; to resolve issues, drive results and meet project target dates as required by management. This individual will work with Client Benefits, Account Management and Implementation management along with senior leadership to improve the overall Quality of the Client Implementation experience. ∙ Analyze client benefit requests, determine best operational approach and perform testing or quality reviews. ∙ Execute test beds and validate coding accuracy utilizing various tools to ensure no financial impact or client/participant dissatisfaction. ∙ Log issues and defects found during testing in SFDC∙ Responsible for meeting or exceeding turnaround time and quality standards. ∙ Research client benefit requests and raise issues/clarifications to internal partners to meet client needs∙ Responsible for performing QA functions such as moving all plan design implementations and/or changes into a Production status upon completion of a review within tight timelines.Pay RangeThe typical pay range for this role is:Minimum: 18.50Maximum: 34.60Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required QualificationsMust live in the Irving, TX area. Will work in office two days, work from home three days1-3 year experience working in the PBM or related work experienceStrong analytical skills and attention to detail Ability to analyze data, interpret requirements, establish facts and draw valid conclusionsKnowledge & Experience in Quality Assurance and testing activitiesWorking knowledge of Microsoft Office applications including Word, Excel, PowerPoint, and AccessPreferred Qualifications1-2 year experience working in PBM or managed care or healthcare industry preferredKnowledge of RxClaim (AS400), EZQuery and EZTest toolsExcellent communication (Verbal and Written) and collaboration skillsCourteous and professional demeanor with the desire and ability to work in a teamAbility to interact and with project leads and SME'sEducationBachelor's degree required; equivalent work experience may substitute.Business OverviewBring your heart to CVS Health Every 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. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Created: 2025-11-15