Job DescriptionThe Clinical Services Consultant will be a Prior Authorization system Subject Matter Expert to provide support for the Prior Authorization/Appeals Operational and Administrative teams. Participate in project and activities related to PA system including configuration and process improvements. In addition will complete the following: Coordinate user acceptance testing for system enhancements; review feedback from user groups and work with IT and the business to develop and deploy system enhancements; create BSR documentation; lead meetings, and work closely with Operations, Legal, and IT Teams to implement system enhancements and projects within the Prior Authorization system meeting both state and federal requirements. In addition, 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*Six months of CAS or CAS PA Admin experience within the CVS Caremark Prior Authorization (Or equivalent internal or external experience)
* Proficiency with Excel, Word and PowerPoint Preferred Qualifications* Strong CAS and/or MedHOK systems knowledge preferred
* Knowledge of Prior Auth and Appeals activities perferred.
* Current or previous PA system setup experience 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).
* 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 Education* High school diploma or GED required
* Bachelor’s degree or relevant work experience preferred Business Overview
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.
CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW
and EEO IS THE LAW SUPPLEMENT
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking EEO AA CVS Health
CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.
For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/