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This includes Prior Authorization / Pre Certification / Concurrent Reviews / Peer to Peer Calls / First Level Appeals / Special Projects and Committee participation when needed. Position Summary :Aetna, a CVS Health Company, is one of the oldest and largest national insurers.
$174,070 - $374,900Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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This position is for a Clinical Pharmacist working in the Prior Authorization team. - Maintains professional and technical knowledge of drug and disease states for the Specialty and Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review Unit (CRU) line of business.
$38.63 - $83.17Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Prior Authorization Utilization Management Nurse Consultant page is loaded. Prior Authorization Utilization Management Nurse Consultant. Previous prior authorization experience.
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As a Clinical Service Representative, you will handle inbound calls from medical offices, physicians and healthcare providers in support of our Prior Authorization Department. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
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Answering in-coming member and provider calls and responding to inquiries regarding benefits, eligibility, services, prior authorization requirements, extra benefits and programs, etc.
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The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and responds to prescriber inquiries related to UM transactions and more generally related to CVS Health coverage policies.
$174,070 - $374,900 a yearFull-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Utilization review, prior authorization, concurrent review, appeals experience preferred. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.
$60,522.8 - $129,600 a yearFull-timeExpandApply NowActive JobUpdated 15 days ago - UpvoteDownvoteShare Job
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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.
$80,340 - $173,000 a yearFull-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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1 year of varied UM (utilization management) experience within an inpatient/outpatient setting, concurrent review or prior authorization. This candidate will work with providers to secure information required for prior authorization review.
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Prior Authorization or Utilization Management experience. Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health.
$26.01 - $62.31 an hourFull-timeExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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As a UM Nurse Consultant you will work in a clinical telephone queue working with providers to secure additional information for prior authorization reviews. As a UM Nurse Consultant you will work in a clinical telephone queue working with providers to secure additional information for prior authorization reviews.
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You will participate in the development, implementation, and evaluation of clinical / medical programs and expand Aetna's medical management programs to address member needs across the continuum of care.
$174,070 - $374,900Full-timeExpandApply NowActive JobUpdated Today
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