Job Summary:
We are seeking a highly skilled and motivated Clinical Settlement Analyst to join our team at CVS Health. As a Clinical Settlement Analyst, you will play a critical role in supporting the Clinical Settlement team, working closely with stakeholders to analyze and resolve complex settlement issues. This is a full-time remote opportunity, offering a competitive salary of $26-$35/hour.
Key Responsibilities:
- Provide expert analysis and support for Clinical Settlement projects, focusing on the Prior Authorization (PA) model and executive settlement
- Work with large volumes of PAs to ensure timely and accurate processing, meeting business needs and requirements
- Collaborate with stakeholders to identify root causes of issues, develop solutions, and implement changes to improve processes
- Utilize RxClaim and participate in business requirement judgments, testing, and documentation for Clinical Settlement projects
- Support CAPAS administration index contributions, integrating enhancements into all aspects of CAPAS tasks
- Ensure timely closure of expectations resulting from division drives and PA activities
Requirements:
- 1-2 years of scientific experience working with large datasets, preferably in a clinical or settlement-related environment
- Strong analytical and problem-solving skills, with the ability to think critically and apply proven thinking and logic
- Excellent communication and organizational skills, with the ability to articulate complex technical concepts to non-technical stakeholders
- Proficiency in Microsoft Office Suite, with experience using MS Access database
- Ability to work independently and as part of a team, with a self-motivated and results-driven attitude
Preferred Qualifications:
- RxClaim experience, specifically settlement connected with PA overrides
- Advanced proficiency in Microsoft Office Suite
- Ability to run queries in RxClaim or Data Warehouse
What We Offer:
- Competitive salary: $26-$35/hour
- Full-time remote opportunity
- Opportunity to work with a leading healthcare company
- Collaborative and dynamic work environment
We encourage you to apply, even if you feel you're not a perfect match. We're looking for great people to join our friendly team!
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