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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary:

As a Medicare Part B Representative, you will work closely with healthcare providers to process Organization Determination (OD) and drug benefit exception requests in a call center environment. In the Clinical Representative role, you will play a meaningful role in ensuring member, prescriber, and client satisfaction. You will be performing all work in accordance with Medicare Part B guidelines.

In this role, you would have flexibility to work any shift between 7:00am-8:00pm CST (Monday - Friday) and alternate weekends Saturday and Sunday.

As a Medicare Part B Representative, you'll show a high level of attention to detail, verbal and written communications skills, and the ability to problem solve in this dynamic work environment. You’ll be working various assignments that require demonstrated urgency and the ability to meet set timelines. You’ll have the opportunity to project a professional business image through phone interactions as well as internal communication.

Your responsibilities will include:

-Working incoming cases via fax to process coverage requests from members or prescribers.

-Conducting outreach to patients and providers, and obtaining additional information needed to process requests.

-Researching and correcting any issues found in the overall process.

-Raising issues to Organization Determination Clinical Pharmacists and Management team as needed.

-Reading, analyzing, and interpreting general business correspondence, technical procedures, and governmental regulations.

-Solving practical problems and dealing with multiple concrete variables in standardized situations.

-Performing basic mathematical calculations.

-Ensuring all cases are properly closed

- Ability to interpret a variety of work instructions provided

through multiple mediums

- Ability to anticipate needs and resolve issues with

urgency and to meet quality and production standards

Schedule flexibility including rotations through Nights,

Weekends and Holiday Coverage

Required Qualifications:

6 months of customer service, pharmacy or related  experience.

Preferred Qualifications:

1 year experience working with Healthcare.

1 year experience working with Microsoft Applications.

Education:

Verifiable High School Diploma or GED required

Pay Range

The typical pay range for this role is:

$17.00 - $25.65

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. 

The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. 

As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. 

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 08/15/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.