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 Complaint Coordinator is responsible for working member grievances (complaints) within required timeframes, spanning from intake to resolution. The review process may require coordination with multiple internal departments within the health plan, as well as external service providers or other delegated entities.
Job duties include (but are not limited to):
Responsible for managing lifecycle of each case and communicating the final resolution to the member or authorized representative.Acknowledge and respond to member complaints orally or in writing.Coordinate issue resolution among multiple departments within required timeframes. Provide guidance/coaching to the service provider on specific cases.Identify and trend systemic problems and make suggestions to improve or reduce the possibility of a reoccurrence.Ensure each resolution appropriately addresses all issues raised in the associate4d complaint.Communicate issue resolution orally or in writing, and monitor timeliness to ensure compliance with case work.
Required Qualifications
Preferred Qualifications
Previous experience with Medicaid.Strong verbal and written communication skills.Experience in customer service & handling complaints.Ability to deescalate difficult situations while displaying compassion and empathy. Ability to identify all reported issues and ensure each issue was reviewed appropriately prior to resolution. Ability to navigate difficult conversations carefully and calmly.Well-organized with ability to work autonomously, manage, prioritize, and meet deadlines.Excellent time management skills.Strong decision-making skills, with the ability to ask leading questions as needed.Associate’s or Bachelor’s degree.
Education
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$17.00 - $28.46This 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: 09/02/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.