Analyst, Audit Support – CGSO

CVS Health

. Support Medicare, Commercial, and Medicaid clients that delegate Prior Authorizations, Organization Determinations, Coverage Determinations and Appeals to CVS Caremark .

Posted 9/17/2026full-timeRemote • Arizona • United StatesMid-LevelSenior💰 $43,888 - $85,068 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Medicare, Commercial, and Medicaid Prior Authorizations, Coverage Determinations, and Appeals, ensuring compliance with CMS guidance. Excels in communication, project management, and delivering timely documentation for audit-related activities.

Highest-signal resume keywords

Medicare Coverage DeterminationPrior Authorization ExperienceMedHOK System KnowledgeExcel ProficiencyExceptional Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Prior AuthorizationCoverage DeterminationAppeals ManagementAudit PerformanceCMS Guidance Application

Soft Skills

Attention to DetailCritical ThinkingMotivationPresentation SkillsFlexibility

Tools & Technologies

ExcelWordAdobe Acrobat ProCutePDF ProCAS System

Industry Keywords

PBMMedicareCommercialMedicaidClient Support

About the role

Key responsibilities & impact

Support Medicare, Commercial, and Medicaid clients that delegate Prior Authorizations, Organization Determinations, Coverage Determinations and Appeals to CVS Caremark
Ensure flawless audit performance
Ensure health plan clients receive accurate, consistent, and timely documentation/files for audit-related activities
Understand and apply CMS guidance and business requirements
Complete assignments with urgency and meet set timelines
Maintain professional internal communication with the Client Audit Team, Account Management Team, Reporting Teams, and other departments
Apply attention to detail, verbal and written communication skills, and critical thinking

Requirements

What you’ll need

3 plus years prior experience with PBM - Commercial and Medicare
Proficiency with Excel, Word and Adobe Acrobat Pro or CutePDF Pro preferred
Strong MedHOK and CAS system knowledge preferred
Motivation, presentation skills, and flexibility are required
Ability to meet strict deadlines
Proven capability to work with people at all levels of an organization
Exceptional communication skills (oral and written)
Knowledge of Medicare Coverage Determination and Appeals activities or Commercial activities preferred
Ability to work across boundaries to achieve goals
Self directed with proven ability to manage and prioritize multiple projects simultaneously and meet deadlines
Energetic and highly motivated to provide exceptional client support and service
High School diploma or equivalent GED

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
CVS Health bonus, commission or short-term incentive program in addition to base pay