Plan Sponsor Service Consultant

$35,360 - $71,032/Yr

CVS Health - Dover, DE

Full-time - Entry Level

Dover, DE

Health and Personal Care Retailers

About the position

This position at CVS Health is focused on processing Medicare members' eligibility discrepancies between the Medicare Enrollment Plan System and the Centers for Medicare and Medicaid (CMS). The role primarily deals with the MAPD/Aetna line of business, while also covering PDP/SSI. The individual will be responsible for ensuring accuracy in enrollment processes, maintaining production and quality standards, and providing feedback to leadership based on trending data.

Responsibilities

• Process discrepancies in Medicare member eligibility.
• Provide trending and feedback to leadership regarding discrepancies.
• Review Policy and Procedures for accuracy.
• Maintain expected production and quality standards.
• Work in multiple systems including MP (MNG), FACETS, EMA.

Requirements

• Knowledge of Aetna systems (MP) and SSI systems (preferred).
• Demonstrates working knowledge of standard enrollment processes and election period hierarchy.
• Ability to learn multiple functions including enrollment reconciliation and Late Enrollment Penalty Status (LEP).
• Ability to provide root cause analysis and process improvement opportunities.
• Strong verbal and written communication skills.
• Ability to work independently and as a team player.

Nice-to-haves

• Ability to prioritize tasks effectively.
• Strong organization skills.
• Problem-solving skills.
• Attention to detail and accuracy.
• Proficient in Microsoft Word, PowerPoint, Excel, Outlook, and Teams.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Employee Stock Purchase Plan.
• Fully-paid term life insurance.
• Short-term and long-term disability benefits.
• Well-being programs.
• Education assistance and free development courses.
• CVS store discount and discount programs with partners.
• Paid Time Off (PTO) and paid holidays.