Clinical Services Representative

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 Representative I, Clinical Services takes in-bound calls from providers, pharmacies, and members etc, providing professional and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team.

The Rep I, Clinical Services will also assist with other duties as needed to include but not limited to: outbound calls, reviewing and processing Prior Auth's received via fax and ePA, monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team.Required Qualifications
- Ability to apply basic computer skills.
- Knowledge of Microsoft Office Suite: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable.
- Keyboard skills are essential.
- Must be able to multitask and utilize multiple system applications simultaneously.
- Basic pharmaceutical knowledge pertaining to terminology, calculations, and protocols.

Preferred Qualifications
- Prior authorization experience
- Must be able to utilize available resources independently and provide high quality work.
- Must be able to absorb presented information, display motivation, seek development and problem solve.
- Ability to adapt and change with workflow and shifting priorities.
- Must possess excellent written, verbal, grammar, and listening communication skills.
- Must be able to deal with a diverse customer base (internal and external) in a friendly and confident manner.
- Ability to maintain confidentiality of PHI (Protected Healthcare Information).
- Associate Degree or Bachelor's Degree

• 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.