CVS Health

Senior Analyst Clinical Services- REMOTE U.S.

2 weeks agoRemote

Job Description
The Clinical Services Senior Consultant will act as the Prior Authorization system Subject Matter Expert providing design support for the Client Support and Prior Authorization/Appeals Operational teams. Consult PA Ops on system setup design based on new regulatory requirements, Support Implementations and/or lead improvement initiatives related to PA system enhancements, design configuration and processes to increase departmental cost savings and efficiencies.

In addition will complete the following: Own and maintain the user acceptance test plans for the PA System; lead discussions to obtain feedback from user groups and work with IT and the business to develop, test, and deploy system enhancements; lead meetings; update BSR documentation; departmental training; 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; and work closely with Operations, Legal, IT Teams, and business partners to identify, design and implement system configuration enhancements and projects within the Prior Authorization system meeting both state and federal requirements; support other critical business needs.

Position can be located anywhere in the U.S.

Pay Range
The typical pay range for this role is:
Minimum: 43,700
Maximum: 97,400

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications
• Strong CAS and/or MedHOK systems knowledge
• Knowledge of Prior Auth and Appeals activities
• Current or previous PA system setup experience
• Proficiency with Excel, Word and Powerpoint.
• 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.
• Ability to meet strict deadlines.
• Motivation, presentation skills, and flexibility are required.
• Proven capability to work with people at all levels of an organization.
• Exceptional communication skills (oral and written).
• 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.

COVID Requirements

COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications
• 3 years of work experience
• 3+ years prior experience in Prior Authorization or Appeals operations preferred

• Bachelor's degree or relevant work experience required
• Pharmacy technician experience preferred

Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Job ID: CVS-2150000BR_95607901