Clinical Services Analyst – CVS Remote Jobs

Job Type: Clinical Services Analyst from home
Location: Texas work from home
Company: CVS Health

Analyst will be in charge of the Prior Authorization (PA) system used for Medicare Part D Coverage Determination and Appeals. The Analyst will collaborate with PA Administration and Medicare Operations to test and validate the Utilization Management (UM) criteria, decision trees, drug lists, and letters that are loaded and operational in the PA system. Finally, the Analyst is in charge of configuring and testing the systems that will be used for Medicare D Open Enrollment. Testing cases and performing regression testing to ensure the quality of PA products for business users.

As an Analyst, you will create and carry out formal test plans to ensure the delivery of high-quality software and that all information systems products and services meet minimum organizational standards and end-user requirements.

Pay Scale

The typical salary range for this position is: 40,560 minimum; 83,400 maximum

Please keep in mind that this range represents the average pay for all positions in the job grade in which this position is located. The actual salary offer will consider a variety of factors, including location.

Qualifications Required

• Previous testing experience of at least one year
• 1+ years of experience in the PBM industry Preferred Qualifications
• 1+ years of experience with Microsoft Office applications such as Word, Excel, and Access

Preferred Qualifications

• Analytical and project management abilities
• Excellent negotiation skills when juggling multiple high-priority business tasks.
• Team player who can also work independently
• Ability to manage multiple complex, ongoing projects while meeting deadlines for critical compliance/accreditation deliverables
• Excellent written and verbal communication skills, as well as presentation abilities
• Experience with proven quality results
• Previous analytical experience is required.
• Experience with Medicare and prior authorization

Education: A verifiable Bachelor’s degree or two years of relevant work experience for every year of degree not completed is required.