[Remote] Customer Service Team Lead at CVS Health

Oklahoma, United States

CVS Health Logo
Not SpecifiedCompensation
Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Health InsuranceIndustries

Requirements

Candidates must possess a High School Diploma or G.E.D. and have a minimum of 3 years of experience as an Inbound/Outbound Queue Associate. Preferred qualifications include experience with Microsoft Office Suite (Word, Excel, Project, PowerPoint, Outlook), familiarity with basic medical terminology, strong customer service skills, and the ability to effectively participate in a multi-disciplinary team. Demonstrated initiative, leadership, effective communication, telephonic, and organizational skills are also required.

Responsibilities

The Customer Service Team Lead will support the coordination of medical services, including intake, screening, and referrals, while promoting quality and effectiveness. They will act as a training resource, mentor, and subject matter expert, performing intake of calls, contacting providers, and utilizing systems to manage member information. Responsibilities include screening requests, approving services, performing non-medical research, maintaining documentation, and promoting internal and external communication. The role involves gathering information for case managers, entering referrals, educating providers, supporting the precertification process, and placing outbound calls for clinical information. Additionally, the Team Lead will assess training needs, act independently, manage activities, assist team members, foster a positive team environment, and identify and report potential quality management issues.

Skills

Customer Service
Team Leadership
Medical Services Coordination
Intake
Screening
Referrals
Authorization
Denial Management
Appeals Process
Documentation
Risk Management
Regulatory Compliance
Accreditation
Confidentiality
Eligibility Verification
Benefits Verification
Coordination of Benefits
EDI

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.

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