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Senior Representative, Clinical Support

AT CVS Health
CVS Health

Senior Representative, Clinical Support

Nashville, TN

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

CVS Health has an exciting opportunity for a Senior Rep within our Prior Authorization & Appeals Administration department. In this role, the Senior Rep will assist the CAS PA Admin supervisor with day to day tactical issues, training, coaching and other business needs. The candidate will also promote a positive working environment and initiate suggestions to continually improve process and protocols within CAS PA Admin. Other responsibilities include assisting the supervisor with standardization of procedures, and dissemination of information to staff; acting as a subject matter expert in CAS PA Admin processes and procedures; communicating clearly and accurately when interacting with all levels of employees, plan participants, physician office and partners ; manage escalated and more advanced CAS PA Admin issues when needed; answer questions and recommend corrective action to address complaints; handles special projects and assignments as designated by the supervisor and/or manager.

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Required Qualifications

- 1+ years of experience in the CVS Caremark Prior Authorization and Appeals Administration department
- Must be considered in good attendance and performance standing
- Requires flexibility to work various shifts between 8am and 8pm

Preferred Qualifications

- Superior PC skills in Windows based applications
- Superior CAS Admin skills
- Excellent verbal and written communication skills
- Superior soft skills * Able to work in a high-paced work environment
- Able to work in a team environment
- Ability to positively deal with changes and promote a positive work environment
- Advanced math skills
- Prefer at least 2 years of experience in a complex, high impact customer service role

Education

High School diploma or equivalent GED

Pay Range

The typical pay range for this role is:

$18.50 - $31.72

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 Benefits | CVS Health

We anticipate the application window for this opening will close on: 11/01/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Nashville, TN, USA
Job ID: CVS-R0401215
Employment Type: Other

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • HSA
    • HSA With Employer Contribution
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Fertility Benefits
    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
  • Financial and Retirement

    • 401(K) With Company Matching
  • Professional Development

    • Tuition Reimbursement
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Diversity, Equity, and Inclusion Program