Medicare Executive Resolution Analyst jobs in United States
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CVS Health · 17 hours ago

Medicare Executive Resolution Analyst

CVS Health is dedicated to building a world of health around individuals, and they are seeking a Medicare Executive Resolution Analyst. This role involves reviewing and responding to Medicare executive member complaints and appeals, working closely with subject matter experts to resolve issues effectively.

Health CareMedicalPharmaceuticalRetailSales

Responsibilities

Reviewing and responding to Medicare executive member complaints/appeals that are sent to the CEO, President, one of their direct reports as well as Better Business Bureau (BBB) and Congressional inquiries
Working with dedicated subject matter experts to fully resolve the issue
Covering a phone line that is open Monday – Friday from 8am to 6pm, in which approximately 2 to 3 hours of shifts will be assigned to you

Qualification

Medicare customer serviceAppealsClaim processing toolsAetna’s systems/workflowsMedicare operations experienceQuality assurance mindsetCase managementCommunication skillsAttention to detail

Required

1+ year of experience in Medicare customer service
1+ year of experience with tools associated with appeals and claim processing (i.e. CATS, ECHS, GPS, SCM, WEB CCI, Plan Sponsor Tool, AST, Claims X-ten, e.Policies, IOP, etc.)
Must have background in Aetna's systems/workflows
Ability to prioritize and manage multiple cases in a fast-paced environment
High School Diploma or higher

Preferred

Excellent written and verbal communication skills
2-5 years of experience in Medicare operations, appeals, grievances, or escalated member complaint resolution
Strong attention to detail and quality assurance mindset

Benefits

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Company

CVS Health

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CVS Health is a health solutions company that provides an integrated healthcare services to its members.

Funding

Current Stage
Public Company
Total Funding
$4B
Key Investors
Michigan Economic Development CorporationStarboard Value
2025-08-15Post Ipo Debt· $4B
2025-07-17Grant· $1.5M
2019-11-25Post Ipo Equity

Leadership Team

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David Joyner
President and Chief Executive Officer, CVS Health
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Chandra McMahon
SVP & CISO
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Company data provided by crunchbase