Member Grievance Analyst

By | September 30, 2022

Job Responsibilities : Member Grievance Analyst

Salary : $17.00 – $27.16 an hour

Company : CVS Health

Location : Remote US

The Member Grievance Analyst is responsible for working member grievances (complaints) within required timeframes from intake to resolution. The review process could require coordination with multiple internal departments at the health plan as well as medical providers or other delegated entities. The Complaint Analyst is responsible for managing the lifecycle of the case and communicating the final resolution to the member or authorized representative Acknowledge and respond to member complaints orally or in writing Coordinate issue resolution among multiple departments within required timeframes Provide guidance/coaching to frontline staff on specific cases Identify and trend systemic problems and make suggestions to improve or reduce the possibility of a reoccurrence Ensure the resolution appropriately addresses all issues raised in the complaint Communicate issue resolution orally or in writing Monitor timeliness and ensure compliance with case work

Pay Range
The typical pay range for this role is:
Minimum: 17.00
Maximum: 27.16

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors including location.

Required Qualifications
Strong verbal/written communication skills required. Must have Medicaid Experience1-3 years’ experience in customer service & handling complaints Ability to deescalate difficult situations while displaying compassion and empathy Ensure each issues was reviewed appropriately prior to resolution Well organized with ability to manage prioritize & meet deadlines of cases Experience with claims and benefits a plus
Must reside in the state of Arizona

COVID Requirements

COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required) where allowable under the law unless they are approved for a reasonable accommodation based on disability medical condition religious belief or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications
Please review required qualifications above

H.S. Diploma GED Equivalent experience.

Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal convenient and affordable.
We strive to promote and sustain a culture of diversity inclusion and belonging every day.
CVS Health is an affirmative action employer and is an equal opportunity employer as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting hiring promotion or any other personnel action based on race ethnicity color national origin sex/gender sexual orientation gender identity or expression religion age disability protected veteran status or any other characteristic protected by applicable federal state or local law.

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