Job Description: Specialty Guideline Management Programs

Employment Type: Full Time Anticipated Weekly Hours: 40 Time Type: Full Time

Position Overview

This position provides processing and communication of Specialty medication prior authorization referrals reviewed by the Case Review Unit for the Specialty Guideline Management Programs. This position collaborates with Customer Service, Benefits Verification and Pharmacy Operations to communicate referral status and determinations. This position is also responsible for fax processing and providing telephone call assistance for prescriber office staff, pharmacies and members based on program criteria. Maintaining complete, accurate and timely documentation of all appropriate information is necessary. This position also works closely with the Case Review Unit Clinician team for clinical support on daily functions. Other duties may also be assigned by the leadership team.

Requirements

• Must be a Hawaii resident.
• 1+ years of experience in customer service or call center environment.
• Must be able to work from home.
• Must have high-speed internet.
• Verifiable High School Diploma or GED.

Preferred Qualifications

• Previous experience in pharmacy or healthcare industry.
• Associate's or Bachelor's Degree.
• Pharmacy Technician License.

Pay Range

The typical pay range for this role is: $17.00 - $34.15

This pay range represents the base hourly rate or base annual full-time salary. 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.

Company Information

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Our people fuel our future. Our teams reflect the customers, patients, members, and communities we serve, and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Benefits

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional, and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options.
• A 401(k) plan (including matching company contributions).
• An employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling, and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access, and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

Application Window

We anticipate the application window for this opening will close on: 08/09/2025

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