At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** The Clinical Adjudication Prior Authorization Support (CAPAS) Team delivers end-to-end support for Member Prior Authorization (PA) override services, partnering closely with both internal stakeholders and external clients. As subject matter experts in PA override functionality, we play a critical role in executing large-scale initiatives and ensuring operational excellence. While the term “PA” encompasses various domains, CAPAS specifically focuses on the configuration and operational management of override records within the RxClaim platform. As a Clinical Adjudication PA Support Analyst, you will play a vital role in supporting Prior Authorization (PA) processes across the enterprise. In this position, you will manage a wide range of PA requests, ensuring timely and accurate support for business operations. Your responsibilities will include maintaining PA records in the RxClaim system- uploading new authorizations, updating existing ones, and researching member PA configurations. You will also generate PA reports from RxClaim, contribute to process improvement and automation efforts, and ensure all process documentation remains current. You are expected to follow established procedures, meet service level agreements (SLAs), and uphold a zero-defect service standard while managing daily workflows. Collaboration is key, especially in identifying and resolving override issues. This role requires a proactive, innovative, and team-oriented approach, with active participation in PA-related projects and initiatives. You must also embody CVS Health’s Heart at Work behaviors by fostering a culture of compassion, accountability, and collaboration—positively impacting the health and well-being of our customers and communities. **Required Qualifications** + 1–2 years of experience in data analysis, including working with large datasets. + 1–2 years of experience with RxClaim, including claim adjudication, prior authorization (PA) overrides, or plan benefits. + 1–2 years of experience creating and running queries in RxClaim or SQL Server. + Proficiency in Microsoft Office Suite, particularly Excel and Access. **Preferred Qualifications** + Experience with Microsoft Power Platform. **Education** + Bachelor’s degree preferred. + 1–2 years of relevant professional experience. + Entry-level professionals with strong theoretical knowledge and a willingness to learn are encouraged to apply. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $43,888.00 - $76,500.00 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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 08/19/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.