Analyst, Member Payments

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The Member Payments Analyst supports the accurate and timely processing of member payment activity across PBM Financial Operations. This role is responsible for researching reconciling documenting and resolving payment-related work tied to member reimbursements recoupments check voids reissues daily balancing SalesForce cases and Compass tasks. The analyst works closely with internal partners to ensure payments are handled accurately audit trails are complete service expectations are met and member/client impacts are understood.

In addition this role partners closely with the Member Impact System (MIS) team to support system enhancements issue identification and resolution testing activities reporting needs and process improvements that improve the member payment experience. The analyst is responsible for developing maintaining and analyzing operational reports that provide visibility into payment activity trends reconciliation results and business performance metrics. This position also collaborates across multiple departments including Operations Technology Finance Member Services and Product teams to support cross-functional initiatives resolve complex issues and drive continuous improvement efforts.

This role plays an important part in helping members receive the best payment experience possible through accurate research timely resolution clear documentation effective partnership and data-driven decision making.

Role Overview

This role requires strong attention to detail sound judgment clear communication and the ability to work through complex payment research from start to finish. The analyst will manage multiple priorities in a fast-paced process-driven environment while following established procedures documenting work clearly escalating issues appropriately and supporting ongoing process improvement across the Member Payments team.

The analyst must also be comfortable interpreting and presenting data creating meaningful reports and insights partnering with the MIS team on system-related initiatives and collaborating with cross-functional stakeholders to identify root causes recommend solutions and support operational excellence.

Required Qualifications

• 2 or more years of experience in a finance or accounting operations role
• Excel skills include ability to manage and present large volumes of data creating/using complex formulas report formatting pivot tables data manipulation and other advanced functions.
• Working knowledge of SAP or similar financial systems; experience with transaction research payment application check review voids reissues or account reconciliation.
• Experience with Salesforce Compass or other case/task management tools.

Preferred Qualifications

• Experience in healthcare PBM finance operations member reimbursement claims or payment processing accounting.
• Experience with RxClaim and other CVS Caremark specific applications.
• Ability to research issues identify trends or discrepancies and determine appropriate next steps.
• Understanding of audit controls documentation standards SOX HIPAA PII/PHI and financial operations compliance expectations.
• Strong written and verbal communication skills including the ability to document actions clearly and explain findings to internal partners.
• Ability to manage multiple tasks meet service-level expectations and escalate issues when additional support or approval is needed.
• Customer-service mindset with the ability to balance timely case resolution accuracy and member/client impact.
• Process improvement cross-training and documentation.
• Experience partnering with technology teams including the Member Impact System (MIS) team to support system enhancements testing issue resolution and process optimization.
• Demonstrated experience creating maintaining and analyzing operational or financial reports including identifying trends risks and opportunities through data analysis.
• Strong cross-functional collaboration skills with the ability to work effectively across Operations Technology Finance Product and Customer Service teams to achieve shared business objectives.
• Experience supporting business initiatives process improvement projects and user acceptance testing (UAT) activities for system changes and enhancements.

Education:

High School Diploma or GED

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

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.

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

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