Advanced Eligibility Consultant

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.

The Analyst, Eligibility (Advanced Analyst) serves as a pivotal resource, entrusted with the stewardship of the organization’s most intricate and high-value client portfolios. This role is characterized by the autonomous management and resolution of multifaceted eligibility issues, requiring the translation of strategic directives and organizational intent into executable, results-driven initiatives with minimal oversight. Advanced Analysts operate in a consultative capacity, engaging cross-functionally with internal departments, external clients, and broker partners to deliver expert guidance and solutions. In addition to functioning as the principal escalation point prior to Manager or Director intervention, Advanced Analysts are responsible for the ongoing development and mentorship of junior staff, the design and implementation of comprehensive training programs, the orchestration and alignment of daily operational objectives, and the identification and execution of process optimization strategies. Subject matter expertise is leveraged to drive continuous improvement and operational excellence across the eligibility function.

Required Qualifications:

• 3-4 years experience as an Eligibility Consultant, with a proven track record of managing complex eligibility and policy data for high-value plan sponsors.

• Advanced proficiency in the accurate and timely processing of eligibility data, ensuring alignment with client requirements and organizational standards.

• Ability to synthesize organizational intent and end-state objectives, operating with a high degree of autonomy to achieve desired outcomes.

• Exceptional organizational skills, with the capacity to manage multiple concurrent priorities in a dynamic environment.

• Demonstrated ability to function both independently and as an integral member of a collaborative team.

• Consistent delivery of precise and timely results, with effective delegation and follow-up as required.

• Experience in coaching and mentoring junior colleagues, including the design, development, and facilitation of transitional training programs to support the seamless integration of new hires from classroom instruction to full productivity.

• Proven ability to identify, recommend, and implement process improvements and operational efficiencies.

Preferred Qualifications:

• Experience in processing policy and eligibility data with a high degree of accuracy and timeliness, ensuring that all services and products consistently align with the specific requirements of plan sponsors.

• Experience in coaching, mentoring, and developing others within a team or organizational setting.

• Demonstrated leadership in complex eligibility operations.

Education

• High School diploma, G.E.D. and equivalent experience

Anticipated Weekly Hours

40

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: 05/22/2026

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