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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

The Business Analytics Specialist serves as the bridge between claims operations and technology. This person analyzes claim trends, data, and process gaps; translates business needs into system requirements; prepares and submits configuration updates in alignment with change management standards; and validates that system changes improve accuracy, cycle time, compliance, and user experience. The Business Analytics Specialist partners closely with Claims, Product, IT (Information Technology)/Configuration, QA (Quality Assurance), and Compliance to drive continuous improvement at scale.

Key Responsibilities

Claims Analysis & Insights

• Perform end-to-end analysis of claims intake, adjudication, and resolution workflows to identify defects, leakage drivers, and optimization opportunities.
• Use data (e.g., denial codes) to build actionable insights and business cases.
• Create clear problem statements, root cause analyses (RCA), and recommendations with measurable outcomes.

System Configuration & Change Submissions

• Translate requirements into precise system configuration requests (e.g., benefit rules, edits, routing, reason codes, pricing logic, eligibility, provider/plan configuration).
• Prepare complete change submissions (e.g., SCRs, QB Tickets), including impact assessment.
• Partner with configuration teams to prioritize, size, and schedule changes; track through approvals to deployment.
• Validate changes through post deployment monitoring; document evidence.
• Identify risks and barriers and collaborate with business partners to improve processes.
• Complete various business reports, including tracking, trending and results.
• Research, analyze, and prepare complex data summaries to document claim activities and reports on its results.
• Perform ongoing research and support tasks for existing systems.
• Influence enhancements to business processes and system infrastructure to improve provider claim experience and compliance.
• Illustrate complex information in a clear concise manner.
• Evaluate available software and data to deliver better business solutions.
• Perform other duties as needed.

Required Qualifications

• 1-2 years of experience with healthcare databases, as well as interpretation and manipulation of related data.
• 1-2 years of experience reading and understanding claims, including a working knowledge of reading and reviewing claim and coding types.
• 1-2 years of experience utilizing QNXT.
• Demonstrated proficiency in Microsoft Office, including an advanced knowledge of Excel.

Preferred Qualifications

• Commutable to the Oklahoma City office, and willingness to work a hybrid arrangement (1-2 days in office per week) if so.
• Excellent verbal and written communication skills.
• Ability to work successfully in a fast-paced and evolving environment.
• Previous experience utilizing SQL.
• Previous experience utilizing Quick Base.
• Strict attention-to-detail.
• Strong organizational and time management skills.
• Ability to self-motivate and problem solve independently.
• Ability to work successfully in a collaborative, team-oriented environment.
• Bachelor's degree and/or technical certification, or equivalent work experience (4+ years of relevant experience + high school diploma or GED).

Education

• High school diploma or GED.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$46,988.00 - $122,400.00

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 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, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 04/30/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.