Senior Analyst, Appeals and Complaints- Remote

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. This position will focus on coordinating expedited resolution of root cause corrective actions. Individual will be focusing on issues that are related to executive escalations that are received in Aetna. These escalations might have associated permanent resolutions that need to be coordinated in a time bound fashion.

• Collaborate with leadership team to define requirements for analyzing root causes and remediation requirements of systemic issues.
• Engage with business owners and subject matter experts to obtain status updates through emails and ad-hoc meeting.
• Review and update Quickbase records and statues based on feedback from business partners to ensure accurate tracking of progress.
• Lead cross-functional meetings with business partners to assist in identifying root causes and explore potential remediation options.
• Deliver monthly and ad-hoc reports on status of ongoing or resolved issues to ensure visibility and informed decision making.
• Applies in-depth knowledge to lead and manage cross-functional projects, ensuring successful planning, execution, and delivery within scope, timeline, and budget.
• Communicates with project teams internally and externally to ensure clarity of roles, responsibilities, and expectations.
• Conducts routine collaboration with stakeholders to define project objectives, requirements, and deliverables, ensuring alignment with business goals.
• Examines project progress, identifying and resolving issues, and communicating updates to stakeholders.
• Administers leadership and guidance to project teams, fostering a culture of teamwork, accountability, and high performance.
• Installs project management best practices, methodologies, and tools to drive efficiency and effectiveness in project execution.

Required Qualifications: Claims and/or Appeals experience required Working knowledge of problem solving and decision making skills Preferred Qualifications: Root Cause Analysis experience MS office experience using Excel and Powerpoint Certified Analytics Professional (CAP) preferred. Project Management Professional (PMP) preferred. Education Bachelor's degree Required Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $112,200.00 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: 06/11/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Remote Skills: Analysis Skills, Best Practices, Budgeting, Corrective Action, Cross-Functional, Establish Priorities, Financial Reporting, Geography, Healthcare, Identify Issues, Incentive Programs, Leadership, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Problem Solving Skills, Project Execution, Project Management Professional (PMP), Project/Program Management, Requirements Management, Root Cause Analysis, Safety/Work Safety, Status Reports, Team Player About the Company: CVS Health Corp CVS Health offers a world of promising job opportunities across a diverse range of careers in everything from corporate and pharmacy roles to retails positions. No matter where you work at CVS Health, your unique skills, talents and abilities are welcome and valued. We recognize and reward greatness and want our employees to know their work is making a difference in the lives of millions. Join us today. Together we can continue making innovative, high-quality health and pharmacy services safe, affordable and accessible – for all. Company Size: 10,000 employees or more Industry: Biotechnology/Pharmaceuticals Founded: 0 Website: https://cvshealth.com/