Clinical Representative II - Med D

Job Description

As a Clinical Representative II, you will work closely with providers to process prior authorization (PA) and drug benefit exception requests in accordance with Medicare D (Med D) regulations. In this role, you will research and conduct outreach via phone or fax to obtain additional information to process coverage requests and complete necessary actions to close cases.

Additional responsibilities for the Clinical Representative include:
-Correcting issues related to PA and exception requests
-Initiating and resolving coverage requests
-Raising issues to coverage determination clinical pharmacists and management team as needed

Required Qualifications
1+ years of experience using Microsoft Office Suites
1+ years of Customer Service experience

Preferred Qualifications
-National Pharmacy Technician Certification
-Excellent verbal and written communication and interpersonal skills with the ability to maintain patient confidentiality
-Demonstrated problem-solving ability and attention to detail
-Ability to work in a rapidly changing environment
-Strong organizational skills
-Ability to read, analyze and interpret general business correspondence, technical procedures and governmental regulations
-Ability to identify and solve practical problems and deal with multiple concrete variables in standardized situations
-Ability to perform basic mathematic calculations maybe required
-Ability to interpret various work instructions provided through several mediums

Verifiable GED or High School Diploma is required

Business Overview
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.

CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking EEO AA CVS Health

CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.

For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website:

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