Analyst, Audit Support – CGSO

Job not on LinkedIn

🔥 30 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $43.9k - $85.1k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Support Medicare, Commercial, and Medicaid clients that delegate Prior Authorizations, Organization Determinations, Coverage Determinations and Appeals to CVS Caremark • Ensure flawless audit performance • Ensure health plan clients receive accurate, consistent, and timely documentation/files for audit-related activities • Understand and apply CMS guidance and business requirements • Complete assignments with urgency and meet set timelines • Maintain professional internal communication with the Client Audit Team, Account Management Team, Reporting Teams, and other departments • Apply attention to detail, verbal and written communication skills, and critical thinking

🎯 Requirements

• 3 plus years prior experience with PBM - Commercial and Medicare • Proficiency with Excel, Word and Adobe Acrobat Pro or CutePDF Pro preferred • Strong MedHOK and CAS system knowledge preferred • Motivation, presentation skills, and flexibility are required • Ability to meet strict deadlines • Proven capability to work with people at all levels of an organization • Exceptional communication skills (oral and written) • Knowledge of Medicare Coverage Determination and Appeals activities or Commercial activities preferred • Ability to work across boundaries to achieve goals • Self directed with proven ability to manage and prioritize multiple projects simultaneously and meet deadlines • Energetic and highly motivated to provide exceptional client support and service • High School diploma or equivalent GED

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program in addition to base pay