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Job description
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.
Position Summary
This role is a senior individual contributor on the Eligibility team, responsible for accurate, timely eligibility processing and resolution of complex enrollment and eligibility issues. Senior Eligibility Consultants operate with increasing independence, manage a high volume of work across shifting priorities, and partner with internal teams, clients, and vendors to drive clear, high-quality outcomes. You’ll also support team capability by mentoring newer colleagues and helping bridge formal training into day-to-day production work.
In this role as a Senior Eligibility Consultant, you will:
Process policy and eligibility data accurately and on time using administration systems to support claim payment and plan sponsor service expectations
Resolve complex eligibility and enrollment issues by investigating discrepancies, identifying root causes, and driving issues to closure
Partner with internal teams, clients, and vendors to coordinate information, remove blockers, and achieve positive outcomes
Anticipate potential issues and take action early to prevent rework, delays, or downstream impacts
Contribute to process improvements that strengthen accuracy, efficiency, and consistency across workflows
Support reporting and data discrepancy work by helping evaluate options, documenting trade-offs, and recommending workable paths forward
Design and deliver transition support for newly hired colleagues as they move from classroom learning into the production environment
Coach and mentor junior team members through side-by-side support, feedback, and knowledge sharing
Manage multiple tasks and shifting priorities while maintaining quality and attention to detail
Contribute as a strong team player who can operate independently when needed
Required Qualifications
2+ years experience industry knowledge and enrollment/eligibility processing experience
Demonstrated comfort with professional email communication, including clear documentation, timely updates, and appropriate tone with internal and external partners
Ability to manage multiple incoming workflows and shifting priorities while staying organized and responsive
Experience supporting internal reporting requirements, including tracking work status, documenting outcomes, and meeting reporting deadlines
Proven ability to meet required turnaround times while maintaining strong accuracy and quality standards
Experience coaching, mentoring, or onboarding others in a production environment
Preferred Qualifications
Direct experience supporting COBRA and/or Eligibility programs, including familiarity with downstream impacts to claims and member experience
Experience handling escalated or exception-based eligibility cases (conflicting inputs, unclear data, complex retroactivity)
Experience identifying root causes of recurring issues and driving small process improvements that reduce rework
Experience supporting transitions (new clients, new processes, or system changes) and helping others ramp successfully
Experience creating or improving job aids, reference guides, or training materials for team use
Education
High School diploma, G.E.D. or equivalent experience.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is: $18.50 - $38.82
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.
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 coverage, dental coverage, vision coverage, paid time off, retirement savings options, wellness programs, other resources. 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.
Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people.
Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.
We anticipate the application window for this opening will close on: 10/02/2026
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Worksite address
east lansing, MI, 48823, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.