Customer Service - Case Manager III

  • Company: CVS Health
  • Location: Louisville, Kentucky
  • Posted: December 02, 2017
  • Reference ID: 731105BR
Position Summary:
Do you love helping people? In this dynamic role as a Case Manager III, you will drive paid therapy outcomes for patients, providers, pharmaceutical company representatives and healthcare service companies for specialty prescription drugs with reimbursement and billing challenges.

Position Summary
  • Coordinate care for patients using the program
  • Conduct Benefit Investigations as necessary
  • Communicate with key medical practice accounts, sales representatives regarding the status of cases. Provide consultative services where issues arise on how obstacles can be overcome in order to get patient on paid therapy
  • Communicate with internal partners to ensure case coordination
  • Updates prescribes and sales representatives on the case statuses
  • Coordinates and schedules weekly conference calls with sales representatives to review status of cases
  • Acts as a partner with pharmaceutical sale representatives in supporting prescriber offices and patients in moving cases to paid therapy
This posting is for the 11:30-8 pm shift.

Required Qualifications:
This position requires registration with the Kentucky Board of Pharmacy. Proof of registration is required prior to being hired .*Please note, additional education or certification is not required, only registration. Assistance will be provided.

Preferred Qualifications:
  • Knowledge of Medical Terminology
  • Working knowledge of drug reimbursement issues
  • Knowledge of HCPCS, CPT and ICD-9 coding
  • Ability to negotiate favorable outcomes with payor and prescribers in obtaining needed information and decisions
  • Ability to express ideas clearly in both written and
    oral communications
  • Exceptional attention to detail, ability to multi-task and adaptable to changing priorities as needed
  • Excellent analytical, investigation, and problem solving skills
  • Strong computer skills; preferably Microsoft Word or Excel software applications
  • Ability to resolve problems independently and to calculate figures and amounts such as discounts and percentages; necessary to provide correct benefit and co-pay information
  • Responsible for meeting quality and turn-around-time objectives for top key account

High School Diploma or Equivalent

RxCrossroads Specialty Solutions, a division of Omnicare Inc., is a wholly owned subsidiary of the CVSHealth Corporation, whom provides tailored services to the biotechnology and pharmaceutical industries. Its partner programs are customized to meet the unique needs of each individual brand through an integrated model that provides comprehensive patient services and enhances product access, affordability, and adherence. RxCrossroads is also the leading provider of logistics services for plasma and other complicated therapies as well as managing large levels of consigned pharmaceutical inventory used in its patient-specific free drug distribution pharmacy distribution program. For more information, visit .

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:

Share this Job