VetJobs - The Leading Military Job Board

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:

Omnicare, Inc. is a wholly owned subsidiary of CVS Health Corporation. www.cvshealth.com

What We Do

Directly, and through our subsidiaries, Omnicare provides a broad array of pharmacy-related services to long term care facilities and to other customers in the health care environment. While senior care has long been an Omnicare specialty, we also serve other targeted populations.

The CIC, Claims associate is responsible for the timely and accurate distribution of phone calls and documents, as well as document storage throughout the CIC. Claims associates will research prior authorization (PA) requirements, gather all PA information needed, and complete the PA procedure in a timely manner. Are required to work with CIC staff, pharmacy staff, nursing facility staff and physician offices to ensure timely payment of online submission of claims and responsible for follow-up on all prior authorizations that have been submitted to the insurer for review.

• Triage all incoming phone calls and faxes.

• File and electronically store all prior authorizations and other CIC related documentation.

• Work rejected real-time claims for all pharmacies supported by the CIC under the direction of the CIC pharmacists.

o Work with local pharmacies to meet run times and ensure timely dispensing of medications. o Work with facility staff to gather pertinent information needed to secure overrides/prior authorizations.

• Initiate Prior Authorizations as directed by a CIC pharmacist or Clinical Specialist.

• Fax and/or electronically submit completed prior authorizations to insurance plans for review.

• Call insurance plans to follow-up on submitted prior authorizations.

• Communicate to the Supervisor staff and then escalate to the Claims Manager any changes in prior authorization criteria or issues related with various insurance plans and processors.

• Work backlog of rejects as appropriate.

• Follow all applicable government regulations including HIPAA.

• Display behavior which exemplifies employee code of conduct guidelines.

Preferred

•Minimum of one-year full-time LTC Pharmacy experience.

•Certified Pharmacy Technician

Required

• Verifiable High School Diploma or GED is required • The ability to concentrate on a task over a period without being distracted • Use and understand verbal and written communication to interact with customers and colleagues • Actively listening by giving full attention to what others are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times • The ability to use math to solve a problem, such as calculating day’s supply of a prescription • Is able to judge when something is wrong or is likely to go wrong; recognizing there is a problem • Choosing the best course of action when faced with a complex situation with several available options • Customer service orientation • Fluent in all aspects of the English Language • Good oral communication skills • Ability to have strong communication with Pharmacists • Ability to effectively communicate with employees, facility staff members, prescribers and others within organization • Ability to write routine correspondence and reports • Excellent skills in usage of fax machine, computer software, copier, and word-processing • Strong attention to detail

Pay Range

The typical pay range for this role is:

$17.00 - $29.88

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. 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 jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 07/31/2024

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.