Medicare Qualification Specialist – Registered Dietitian

Job not on LinkedIn

🕒 July 23

🇺🇸 United States – Remote

💵 $21 - $43 / hour

⏰ Full Time

🟢 Junior

👻 Ghost score 24%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

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 safe, high-quality, patient-centered nutrition support services, including parenteral nutrition and enteral tube feeding • Review clinical documentation to determine qualification under Medicare standards • Support documentation for payer requirements and reimbursement • Collaborate with internal and external customers to support transitions to Coram CVS/specialty infusion services, continuity of care, and customer satisfaction • Support mentoring and training for RDs and non-clinical staff • Develop and analyze operational and clinical reports • Support program initiatives and scheduling activities as assigned • Maintain accurate and complete clinical documentation for patient care, medical necessity, payer requirements, and reimbursement • Assist with qualification and documentation of medical necessity for parenteral and enteral therapies • Support path-to-payment conversations with prescribers and patients • Support the appeals process • Collaborate with partners to support patient care and provide education on nutrition support services • Educate internal staff and external customers on nutrition therapy, policies, procedures, and reimbursement topics • Lead or participate in nutrition support team meetings and patient care conferences • Provide patient and caregiver instruction on home medical nutrition therapy as ordered • Partner with sales and business partners to provide clinical expertise, customer education, and support growth opportunities

🎯 Requirements

• 1+ years of experience as a Registered Dietitian working with nutrition support (i.e., Enteral and TPN) • Knowledge of applicable state clinical and regulatory requirements • Current license as a Registered Dietitian in the state of residence, where required • Willingness to obtain additional state licensure as needed to support patient care needs • Working knowledge of Microsoft business software • Strong verbal and written communication skills • Ability to provide clear instructions to patients, caregivers, healthcare providers, and internal partners • Ability to complete accurate clinical documentation • Experience providing exceptional customer service by responding to medical professionals and patients with accurate and timely information • Strong problem-analysis and decision-making skills • Ability to address and resolve conflict effectively • Ability to work effectively in teams and coordinate work efforts across multiple stakeholders • Excellent organizational and time management skills • Ability to manage competing priorities in a high-volume, fast-paced clinical environment • Ability to perform additional duties as assigned by the supervisor or manager • Bachelor’s degree in Nutrition, Dietetics, or a related field • Preferred: Experience providing home nutrition support care • Preferred: Certified Nutrition Support Clinician (CNSC) for those with direct patient assessment/clinical care responsibilities • Preferred: Knowledge of payer requirements related to billing and reimbursement • Preferred: Experience using electronic medical record systems

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility