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CVS Health Assistant I Clinical FEP in Phoenix, Arizona

Job Description

The Clinical Assistant I FEP functions as a primary contact to handle escalated, incoming and outgoing calls, faxes/letters from or to physicians and health care providers in support of the Prior Authorization (PA) Department. As a Clinical Assistant I, you will analyze clinical algorithms and provide decisions regarding PA Requests. You will also have use of online databases and other resources to document appropriate recommendations, clinical decisions and responses. Providing ongoing education on the PA Program is also critical to this role. This includes education of the appeal process to healthcare providers and internal partners. It's imperative that our Clinical Assistants deliver the highest quality health care and customer service to health care providers or internal providers in a high paced dedicated PA program. 

As a Clinical Assistant I, you must have knowledge of FEP account and client parameters, the ability to prioritize and manage multiple demands while meeting deadlines, and you must possess excellent verbal and written communication skills. A successful Clinical Assistant has good time management and analytical skills, and working knowledge of pharmaceutical medications. Our Clinical Assistants must be detail and team oriented, also comfortable working independently and prioritizing tasks, and must demonstrate a professional attitude.

Working knowledge of the following computer programs: Microsoft Suite, RxClaims, PA database applications, is required. The ability to achieve FEP specific service levels and contractual obligations (determined by client) through team motivation is also critical to the success of the team.

Required Qualifications

6+ months Managed Care experience

1+ year FEP Prior Approval department experience

Must be member of FEP PA department

Preferred Qualifications

Managed Care experience, highly preferred

Flexible work schedule to meet changing department needs

Working knowledge of the FEP account and client parameters

Ability to meet contractual obligations and achieve FEP specific service levels through team motivation

Working knowledge of FEP computer programs

Ability to be flexible and adaptable to change

FEP Prior Approval experience

Education

Verifiable High School diploma or GED is required

Bachelor’s Degree preferred

Post High School or specialized training, such as PTCB Certified and Arizona Licensed Pharmacy Tech preferred

Business Overview

It’s a new day in health care.

Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.

We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.

CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf and EEO IS THE LAW SUPPLEMENT at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm . We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team at mailto:AdviceCounsel@cvshealth.com . Please note that we only accept applications for employment via this site.

If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or cvshealthsupport@us.ibm.com . For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352.

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