About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This position provides processing and communication of Specialty and Non-Specialty medication prior authorization referrals reviewed by the Case Review Unit. 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. Schedule - 40 hour work week, Monday through Friday 8:30 AM -5:00 PM HST

Requirements

  • Must be Hawaii resident
  • 1+ years' experience in customer service or call center environment
  • Must be able to work from home, this is a 100% work from home position
  • Have wired high speed internet
  • High School Diploma or equivalent GED

Nice To Haves

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

Responsibilities

  • processing and communication of Specialty and Non-Specialty medication prior authorization referrals reviewed by the Case Review Unit
  • collaborates with Customer Service, Benefits Verification and Pharmacy Operations to communicate referral status and determinations
  • fax processing
  • 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
  • works closely with the Case Review Unit Clinician team for clinical support on daily functions

Benefits

  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and 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.
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