CVS Health
Healthcare Insurance • Retail • Wellness
CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.
Senior Clinical Consultant – Wheelchair DME
Job not on LinkedIn
November 20
CVS Health
Healthcare Insurance • Retail • Wellness
CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.
📋 Description
• Provide clinical expertise and business direction in support of medical management programs • Support the appeal process, clinical claim review process, pre-certification, and predetermination of covered benefits • Participate on work groups as a clinical subject matter expert to improve healthcare services • Apply clinical coding and reimbursement expertise to ensure alignment with Aetna policies • Use data analysis to identify quality improvement opportunities • Collaborate and lead teams of health delivery professionals
🎯 Requirements
• Assistive Technology Professional (ATP) Rehabilitation Engineering & Assistive Technology Society of North America (RESNA) certification • 7-10 years clinical practice experience, e.g. hospital, professional practice • One year or more of health plan/payor experience • Current (or eligible) for at least one state license in physical therapist or occupational therapist • Seating Mobility Specialist (SMS) Rehabilitation Engineering & Assistive Technology Society of North America (RESNA) certification preferred • Proficient in Microsoft Word, Excel and other computer software
🏖️ Benefits
• Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching • Paid time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical access
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