Clinical Services Consultant

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.

Position Summary

The Clinical Services Consultant will be a Prior

Authorization system Subject Matter Expert to provide

support for the Prior Authorization/Appeals Operational and

Client Support teams. 

Additional responsibilities to include but not limited to the following:

- Participate in project and activities related to PA system

including configuration and process improvements. 

- Coordinate and assist in executing user acceptance

testing for system enhancements; review feedback from

user groups and work with IT and the business to develop

and deploy system enhancements; Document ideas for

enhancements; facilitate meetings, and work closely with

Operations, Legal, and IT Teams to implement system

enhancements and initiatives within the Prior Authorization

system meeting both state and federal requirements.

- Acts as a subject matter expert in processes and

procedures. 

- Works closely with internal partners to develop work

instructions and process improvements.

- Works collaboratively with internal business partners,

including the RPh team and account teams, to provide

solutions for customers.

- Responds to customer satisfaction expectations through

regular and consistent attendance, scheduling flexibility

and availability.

- Assists supervisors with day to day tactical and

production issues and handles special projects and

assignments as designated by management.

Required Qualifications

- 1 plus years of equivalent experience

- 2 plus years of CAS knowledge.

- Knowledge of Prior Authorization and Appeals activities.

Preferred Qualifications

- Ability to exercise high discretion on sensitive and

confidential matters.

- Demonstrates strong analytical skills with the ability to

evaluate, develop, and deliver alternative courses of

action.

- Ability to positively deal with changes in a complex and

rapidly changing environment and promote a positive work

environment

Education

High School Diploma or equivalent GED

Pay Range

The typical pay range for this role is:

$18.50 - $35.29

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. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
 
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits<