Clinical Support 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.

About the Role

The Clinical Analyst role on the CVS Aetna IBU team is a great opportunity for an individual with analytical interest and skills. The individual will work with clinical data and tools to help the Clinical Advisors provide strategic consultation and deliverables.

Responsibilities

• Supports clinical advisors to meet client reporting requirements and deliverables, both scheduled and ad hoc.
• Support clinical advisors on data needed to support PA Criteria submission to configure internal utilization platforms (CAS and MedHOK).
• Supports clinical advisors to help communicate client formulary changes to internal partners.
• Support clinical advisor with Prior Authorization monthly updates, extensions and migrations, working with IBU data analysis team, Account Management, and PBM Clinical PA team.
• Clarifies needs and suggests innovative ideas to meet client/clinical advisor requests.
• Provides consultative analysis of results and suggests additional analysis, if appropriate.
• Consistently performs quality checks on reports/deliverables and ensures data is accurate before sharing with clinical advisor.
• Proactively suggests solutions and integrates best practices across accounts.
• Request, interpret and analyze claims data for impact and remediation.
• Suggests and creates innovative solutions for improving existing process flows.
• Special projects and workgroups as needed to improve efficiency and client satisfaction.

Requirements

• 2+ years of work experience working with healthcare data, preferred pharmacy data.
• 3+ years of experience in Microsoft Office suite including proficient skills utilizing Outlook, Access, Word, Excel, and PowerPoint.

Preferred Qualifications

• Pharmacy experience.
• Medicare Experience.
• Pharmacy Technician certification.
• Strong Communication skills.
• Ability to work at a fast pace.
• Critical thinking skills.
• Strategic thinking skills.
• Ability to work in a team setting.
• Ability to demonstrate strong problem-solving skills.
• Ability to work independently and effectively manage workload.
• Client Facing/consultation experience.
• Process flow improvement experience with Visio.
• Ability to create macro-enabled Access/Excel tools.

Qualifications

High School Diploma or equivalent GED.

Pay

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.

Benefits

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.

Schedule

• Anticipated weekly hours: 40.
• Time type: Full time.