
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.
🕒 September 21
Where this job comes from
Posted on CVS Health's careers page, not through a job board
First seen by Remote Rocketship September 21
Still open on CVS Health's site. Checked 7 hours ago.

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.
• Process prior authorization requests received by phone, fax, or electronically • Use computer resources, existing criteria, and medication guidelines to perform clinical research supporting prior authorization reviews • Complete prior authorization approvals and denials that are due to expire • Maintain complete, timely, and accurate documentation • Review potential prior authorization denial language for NCQA requirements • Follow prior authorization workflows, policies, and procedures • Answer high-volume inquiry calls from provider offices, pharmacies, and internal partners • Communicate prior authorization status or decisions using multiple computer resources • Balance productivity, quality, and timeliness • Participate in required training, continuing education, and team or departmental meetings • Pronounce drug names and diagnoses, recognize medical terminology, and navigate multiple computer resources
• National Pharmacy Technician certification and Arizona State Pharmacy Technician license, current and in good standing, required and must be maintained • Between 1-5+ years of Pharmacy Prior Authorization processing experience • Ability to multi-task and prioritize work • Ability to adjust based on business or department needs • Good organization skills • High school diploma or G.E.D. • Own home internet access with minimum speed of 100 Mbps download • Secure workspace/office in the home • High-level PC skills, including using a mouse and keyboard and navigating multiple systems and screens • Ability to work 40 hours per week as scheduled, including weekends and holidays • Ability to work extended hours when necessary • Rotating weekend schedule may be required • Retail or hospital experience preferred • Managed Care or Medicaid experience preferred • AS400 experience preferred • Proficiency with computerized resources and software applications preferred • Proficiency with Microsoft applications (Excel, Word, and Outlook) preferred • Knowledge of pharmacy practices and procedures, and ability to read and understand clinical information preferred • Working knowledge of drug dosage forms, drug strength, and generic and brand name equivalents preferred
• CVS Health bonus, commission or short-term incentive program in addition to the base pay range • 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
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🟢 Junior
🟡 Mid-level
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