Clinical Services Representative at CVS Health

Texas Twp, Michigan, United States

Apply with AI Apply

Not SpecifiedCompensation

Entry Level & New Grad, Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, PharmaceuticalsIndustries

Requirements

Candidates must possess a high school diploma or equivalent GED, basic computer skills, and knowledge of Microsoft Office Suite (Excel and Word required). Essential keyboard skills, the ability to multitask and use multiple systems simultaneously, and basic pharmaceutical knowledge are also necessary. An Associate's or Bachelor's degree, prior authorization experience, and excellent communication, problem-solving, and adaptability skills are preferred.

Responsibilities

The Clinical Services Representative will handle inbound calls from providers, pharmacies, and members, assisting them through the prior authorization process and maintaining accurate documentation. They will transfer clinical inquiries and escalations to the pharmacist team. Additional duties include making outbound calls, processing prior authorizations received via fax and ePA, and responding to inquiries from department mailboxes.

Skills

Microsoft Office Suite

Excel

Word

Access

Outlook

PowerPoint

Visio

Keyboard skills

Multitasking

System applications

Pharmaceutical terminology

Pharmaceutical calculations

Pharmaceutical protocols

Prior authorization

Problem-solving

Adaptability

Written communication

Verbal communication

Grammar

Listening skills

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

Land your dream remote job 3x faster with AI

Try Jobo Free