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 SummaryThe Clinical Services Consultant fulfills the company purpose of helping people on their path to better health by driving quality execution of administrative support for Prior Authorization. The Clinical Services Consultant will be a Prior Authorization system Subject Matter Expert providing support for the Prior Authorization/Appeals Operational and Administrative teams. This position works closely with and fosters communications with internal and external departments including clinical development, product owners, CAS liaisons, Account Teams and Prior Authorization Operations to ensure a solid understanding of the programs being processed and implemented.
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In order to be successful in this role you will interact and collaborate with internal colleagues to identify opportunities to improve processes and drive efficiencies within the department as well as assist in leading meetings, creation and maintenance of work instructions, training, projects and activities related to PA systems. Consultants also work with a team of system trainers to provide consistent back end user support, assist in documentation and maintenance of user guides presentations and corrective action plans, provide system demos and help guide CAS users through the implementation process for Prior Authorization system tool.Required Qualifications
- 3 plus years of Pharmacy Benefit Management (PBM) prior authorization experiencePreferred Qualifications
- Experience with PA system setup
- Experience with MS Excel, Word and PowerPoint
- Experience with CAS and/or MedHOK systems
- Experience with Prior Auth and Appeals activities
- Experience with previous project management.
- Bachelor's Degree in any related field EducationEducation
High School Diploma or equivalent GED Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:$18.50 - $35.29This 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 peopleWe 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.