Client Operations - Analyst

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. As a Specialty Benefits Analyst, you are responsible for analyzing client requests and performing the necessary specialty benefits coding and quality assurance activities. You’ll work alongside other benefit coders, testers, and quality assurance representatives, as well as our Account, Clinical Requirement Advisors, and implementation management teams to deliver high quality support to our clients. Attention to details is important for this role, as you’re coding and quality assurance activities will impact clients at CVS Health. This position is responsible for analyzing and evaluating changes for updating RxCLAIM and using Salesforce to work cases from a queue. You will be expected to execute with high level of accuracy, responsiveness, and reliability while performing job functions. Primary Job Duties & Responsibilities: Responsibilities Follow policies and best practices relating to the job function by analyzing client requests, determine the best operational approach and install adjudication related drug lists in Salesforce and RxClaim/AS400. Collaborate regularly with peers to audit, review and verify drug list coding and testing while utilizing various tools. Analyze and evaluate changes related to specialty pricing and access Meet all turnaround time and performance guarantees with excellent quality. Capable of applying logical thinking to identify process improvement opportunities. Handle requests in a timely fashion without being asked Demonstrates ability to learn and apply increasingly complex concepts, policies, and procedures Support team members by providing peer reviews Essential Qualifications and Functions: Knowledge of: • Microsoft Office applications • 2-3 years of direct work experience with PBM knowledge • Advanced knowledge of AS400 / RxCLAIM platform, system application, and products • Advanced SalesForce.com Skill In: • Time management, Organizing and prioritizing non-routine tasks • Verbal and written communication • Analysis and attention to detail • Interpersonal and collaborative skills Ability To: • Prioritize work effectively and independently • Experience analyzing and executing clinical and/or non-clinical work requests • Ability to learn and apply increasingly complex concepts, policies, and procedures • Flexible in adapting to change • Customer focused Preferred Qualifications: Knowledge of: • 1-2 years of related work experience Skill in: • Pharmacy Technician license Ability To: • Provide peer reviews Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $43,888.00 - $85,068.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 02/19/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Apply tot his job Apply To this Job