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Membership Operations Analyst

Work from home Full-time role Hiring

CVS Health is focused on building a connected and compassionate health experience for individuals. The Membership Operations Analyst will manage a book of business, oversee transactions with medical partners, resolve errors, and implement services for new clients. Strong relationship management and independent work skills are essential for success in this role.

Responsibilities

  • Managing a book of business
  • Representing the Integrated Accumulations Department for CVS/Caremark when working with the assigned Medical Partners/Vendors
  • Accountable for interactions with the assigned medical partner/vendor
  • Overseeing the transactions shared between the Medical Partner and CVS/Caremark
  • Resolving transaction errors either internally or with the help of the Medical Partner
  • Investigating and researching the source of errors
  • Correcting errors by using the Department’s standard processes and tools
  • Partnering across work streams with other internal resources to ensure errors are corrected in a timely and efficient manner
  • Representing Integrated Accumulations on cross-functional work teams to resolve specific client issues
  • Meeting operational metrics and providing results for their book of business to the department leadership
  • Implementing service for new clients with existing Medical Partners
  • Working with cross-functional Implementation teams to setup and configure the sharing of transactions within the project plan timeline

Skills

  • 1+ years of related professional work experience
  • At least 1 year of experience managing a collaborative relationship, either with internal or external partners
  • 1+ year of experience using data to solve problems and/or process issues
  • 1+ year of advanced Microsoft Excel experience
  • High School Diploma Required
  • Analyze data and processes to identify issues and root causes
  • Support resolution of routine business and operational issues
  • Prioritize tasks, manage deadlines, and escalate risks as needed
  • Collaborate with cross‑functional internal partners
  • Operate effectively in a fast‑paced, matrixed environment
  • Adapt to changing priorities and organizational needs
  • Maintain high standards of integrity, accuracy, and accountability
  • Proficient in Microsoft Office; healthcare or PBM experience a plus
  • Bachelors Degree or Equivalent Work Experience preferred

Benefits

  • Medical, dental, and vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Other resources, based on eligibility

Company Overview

  • CVS Health is a health solutions company that provides an integrated healthcare services to its members. It was founded in 1963, and is headquartered in Woonsocket, Rhode Island, USA, with a workforce of 10001+ employees. Its website is https://www.cvshealth.com/.
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