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Experienced Clinical Settlement Analyst for CVS Health Work From Home Opportunity - $26/Hour

Remote, USA Full-time Posted 2025-11-03

Join the CVS Health Team as a Remote Clinical Settlement Analyst

CVS Health is revolutionizing the healthcare industry, and we're looking for talented individuals to join our team as Clinical Settlement Analysts. As a fully remote opportunity, you'll have the flexibility to work from home while driving success in a dynamic and fast-paced environment. With a competitive salary of $26-$35 per hour, this role offers a unique blend of challenge, growth, and reward.

About CVS Health and the Role

CVS Health is a leading healthcare company dedicated to improving the health and wellbeing of our customers. As a Clinical Settlement Analyst, you'll play a critical role in maintaining the high volume of Prior Approvals (PAs) and driving business success. You'll be responsible for upholding the PA topic focused on the model, utilizing management settlement, and collaborating with cross-functional teams to identify root causes of overriding issues.

Key Responsibilities

  • Maintain and manage the large volume of PAs to support business operations
  • Navigate RxClaim, participate in business necessity judgments, testing, and documentation for Clinical Settlement projects
  • Collaborate with teams to identify root causes of overriding issues and drive resolution
  • Work on closing expectations resulting from division initiatives and PA activities in a timely manner
  • Support CAPAS administration index contributions and integrate innovative enhancements into all parts of CAPAS operations
  • Support execution of client PA records during the Clinical review portion of the data migration process

Essential Qualifications

To succeed in this role, you'll need:

  • 1-2 years of analytical experience working with large datasets for initiatives or opportunity identification
  • Strong analytical and problem-solving skills, with the ability to think critically and apply proven reasoning and logic
  • Excellent communication and organizational skills, with the ability to articulate complex/technical concepts to non-technical/lay audiences
  • Self-motivation and a strong work ethic, with the ability to work independently in a remote environment

Preferred Qualifications

To stand out as a candidate, you'll ideally have:

  • RxClaim experience, specifically settlement related to PA overrides
  • Advanced proficiency in Microsoft Office Suite
  • Ability to run queries in RxClaim or Data Warehouse
  • Experience using MS Access database

Skills and Competencies

To excel as a Clinical Settlement Analyst, you'll need to possess:

  • Strong analytical and problem-solving skills
  • Excellent communication and collaboration skills
  • Ability to think critically and drive resolution
  • Strong organizational skills, with attention to detail and ability to prioritize tasks
  • Adaptability and flexibility in a fast-paced environment

Career Growth Opportunities and Learning Benefits

At CVS Health, we're committed to helping our employees grow and develop their skills. As a Clinical Settlement Analyst, you'll have opportunities to:

  • Develop your analytical and problem-solving skills
  • Enhance your knowledge of RxClaim and Clinical Settlement processes
  • Collaborate with cross-functional teams to drive business success
  • Participate in training and development programs to stay up-to-date on industry trends and best practices

Work Environment and Company Culture

As a fully remote employee, you'll enjoy the flexibility to work from home while being part of a dynamic and collaborative team. At CVS Health, we value:

  • Diversity, equity, and inclusion
  • Collaboration and teamwork
  • Innovation and creativity
  • Employee wellbeing and work-life balance

Compensation, Perks, and Benefits

We offer a competitive salary of $26-$35 per hour, as well as a comprehensive benefits package that includes:

  • Medical, dental, and vision insurance
  • 401(k) retirement savings plan
  • Paid time off and holidays
  • Opportunities for career growth and development

Ready to Apply?

If you're a motivated and talented individual looking for a challenging and rewarding role, we encourage you to apply now! As a Clinical Settlement Analyst at CVS Health, you'll be part of a dynamic team driving business success and improving the health and wellbeing of our customers. With a competitive salary, comprehensive benefits, and opportunities for growth and development, this is an opportunity you won't want to miss.

Join our team today and take the first step towards a fulfilling and successful career!

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