Clinical Services Consultant – CVS Remote Jobs

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

Responsibilities:

The Prior Authorization system Subject Matter Expert for Clinical Services-PA Admin will help the Prior Authorization/Appeals Operational and Client Support departments. To ensure that programs are handled and implemented effectively, this position collaborates closely and promotes communication with internal and external departments such IT Teams, Clinical Development, Liaisons, Account Teams, and Prior Authorization Operations. The Clinical Services Consultant will take part in projects and activities related to the Prior Authorization system, such as process and configuration improvements, help with user acceptance testing for system enhancements, managing internal workflows for particular lines of business, such as case management, and utilizing user group feedback to collaborate with Business Intelligence, IT, and the business to aid in the development and deployment of system enhancements. Meeting facilitation, ensuring that projects and system upgrades adhere to both state and federal regulations, and departmental training.

Additionally, collaborate with a group of system trainers to deliver consistent back-end user support, help with the documentation and upkeep of user guides, presentations, and corrective action plans, deliver system demos, and serve as a subject matter expert for their team while mentoring and providing support.

Build client configuration within the PA system, as well as testing and quality assurance to make sure client buildouts satisfy client and operational demands to ensure teams are in compliance. coordinating the PA System rollouts through collaboration with internal and external partners to collect and record client requirements, state laws, and Caremark Prior Authorization department standards. 40% Produces, updates, and disseminates documentation for the PA System and processes. 20% Offers continual assistance to both internal and external partners, such as by supporting meetings, projects, and the application of procedures. serving as a point of contact between account management, PA Operations, and PA Admin. builds and maintains cooperative relationships with account team members, IT contacts, client contacts, PA administration leaders, and operation leaders in order to effectively meet the demands of our clients. 20% Closely collaborating with IT, submitting BSR requests in accordance with client, operational, and legal standards. taking part in beta testing and user acceptance testing for the PA System Release. 10% Help other employees with the numerous tasks necessary for them to perform their jobs well. Organize Prior Authorization System demonstrations for partners and internal and external system users. 10%

Pay Spiral

The usual pay scale for this position is as follows: 18.50 minimum; 34.60 maximum

Please remember that this range represents the salary range for every position in the job grade that this position belongs to. The location is just one of several variables that will be considered when determining the actual compensation offer.

Requirements:

Required credentials

• Excel, Word, and PowerPoint proficiency
• Strong knowledge of PA systems.
• Outstanding communication abilities (oral and written).
• familiarity with the actions of Prior Auth and Appeals
• Having put up a PA system before or currently
• Self-motivated with a track record of successfully managing, prioritizing, and juggling many projects at once.
• Create and keep training materials and documentation up to date.
• Conduct online lectures and training sessions
• Organize and prioritize work streams for a certain line of business, manage quality assurance efforts on other people’s work.
• Expert in the field to help coworkers with problems they run into throughout regular work tasks
• data entry knowledge
• Experience in project assistance

Preferred Requirements

• Motivated, flexible, and good in presentations.
• The capacity to meet demanding deadlines.
• A track record of working well with individuals across all organizational levels.
• The capacity to cross barriers in order to accomplish goals.
• Energetic and driven to deliver outstanding customer service and support
• Encourage the leadership in problem-solving
• Monitor and connect data for reporting
• Investigate reported issues
• Education GED equivalent or high school diploma