Eligibility 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.

Position Summary

CVS/Caremark, the Pharmacy Benefit Management (PBM) division of CVS Health, is looking for an Eligibility Analyst to join our Eligibility Administration Department. As an Eligibility Analyst for a Fortune 10 organization, you will impact and support customers in all areas including Commercial, Medicare, Medicaid, & Healthcare Plans.

Primary Responsibilities Of The Eligibility Analyst Include

• Acting as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocol for clients
• Researching and consulting to improve healthcare data integrity and ensure excellent service delivery
• Constantly improving healthcare analytical skills that are needed to perform data analysis
• Resolving data enrollment issues on a daily basis
• Consulting on healthcare data needs
• Having exceptional time management and healthcare client management skills
• Continuous development training will be provided in this role to ensure the Eligibility Analyst is able to exceed client expectations in this fast-paced environment

Required Qualifications

• 1+ year(s) in healthcare data eligibility, insurance, IT, benefits, or data analytics environment with a strong ability to work independently, problem solve, and analyze data in a confidential healthcare environment
• 2+ years customer service experience in a fast-paced environment
• Strong written and verbal communication skills
• Ability to communicate with business clients and stakeholders in a professional manner

Preferred Qualifications

• 3+ years experience in eligibility or other relevant background
• Experience in EDI (Electronic Data Interchange)
• Understanding of the PBM industry
• Familiarity with RxClaim and/or AS400
• Pharmacy technician or benefits verification experience

Education

High School Diploma (required); Associate's degree or 2 years of PBM or healthcare experience (preferred)

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The Typical Pay Range For This Role Is

$43,888.00 - $93,574.00

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 05/14/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.