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Cvs Prior Authorization Remote Jobs in Florida (NOW HIRING)

Coral Connect LLC

Intake Specialist

Boca Raton, FL · On-site +1

$16.75 - $22.50/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Ensure all required elements are obtained prior to benefits investigation and authorization ... Location: Remote with limited travel to client locations, internal business meetings, and other ...

New

Elevance Health

Utilization Management Rep I (contract)

Tampa, FL · Remote

$35K - $40K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Prior authorization, claims, or insurance experience. * Strong communication, customer service, and ... The position is remote. The training will be onsite in the Tampa office for 1-2 weeks. * 5411 Sky ...

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Cvs Prior Authorization Remote information

What is a CVS Prior Authorization remote?

A CVS Prior Authorization Remote job involves reviewing and processing medication prior authorization requests for CVS Health from a remote location. Employees in this role evaluate whether prescribed medications meet insurance requirements and communicate with healthcare providers or patients as needed. The job typically requires strong attention to detail, excellent communication skills, and a background in pharmacy or healthcare. Working remotely allows for flexibility while ensuring timely and accurate authorization decisions.

What are the primary responsibilities of a CVS Prior Authorization Specialist working remotely, and how do they collaborate with other healthcare professionals?

As a remote CVS Prior Authorization Specialist, your main duties involve reviewing and processing prior authorization requests for prescription medications, ensuring compliance with clinical guidelines and insurance requirements. You will regularly communicate with physicians, pharmacists, and insurance representatives to gather necessary information and clarify any discrepancies. Collaboration is typically conducted via secure digital platforms, phone, or email. The role requires strong attention to detail, timely decision-making, and the ability to work independently while maintaining high productivity standards in a virtual team environment.

What is the difference between Cvs Prior Authorization Remote vs Cvs Pharmacy Technician?

AspectCvs Prior Authorization RemoteCvs Pharmacy Technician
Required CredentialsCertification in healthcare or pharmacy-related fields, knowledge of insurance and prior authorization processesState pharmacy technician license, certification (e.g., PTCB), knowledge of pharmacy operations
Work EnvironmentRemote, administrative setting focused on insurance and authorization tasksIn-store or pharmacy setting, assisting pharmacists and customers
Employer & Industry UsageHealthcare and pharmacy companies, insurance providersRetail pharmacies, healthcare providers
Common Search & Comparison IntentUnderstanding remote administrative roles in pharmacyUnderstanding pharmacy technician roles and responsibilities

While Cvs Prior Authorization Remote involves handling insurance approvals remotely, Cvs Pharmacy Technicians work directly in pharmacies assisting with medication dispensing. Both roles require pharmacy-related knowledge but differ in work environment and specific credentials.

What are the key skills and qualifications needed to thrive as a CVS Prior Authorization Specialist remote, and why are they important?

To thrive as a CVS Prior Authorization Specialist (Remote), you need a solid understanding of pharmacy benefits, insurance processes, and medical terminology, often supported by a pharmacy technician certification or relevant experience. Familiarity with prior authorization systems, electronic medical records (EMRs), and CVS-specific platforms is typically required. Strong attention to detail, excellent communication, and problem-solving abilities are crucial soft skills for efficiently handling patient and provider inquiries. These competencies are essential for ensuring accurate and timely medication approvals, which directly impact patient care and satisfaction.

What are the most commonly searched types of Cvs Prior Authorization jobs in Florida?

The most popular types of Cvs Prior Authorization jobs in Florida are:

What are popular job titles related to Cvs Prior Authorization Remote jobs in Florida?

For Cvs Prior Authorization Remote jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Cvs Prior Authorization Remote jobs in Florida look for?

The top searched job categories for Cvs Prior Authorization Remote jobs in Florida are:

What cities in Florida are hiring for Cvs Prior Authorization Remote jobs?

Cities in Florida with the most Cvs Prior Authorization Remote job openings:

Cvs Prior Authorization Remote jobs near you
Infographic showing various Cvs Prior Authorization Remote job openings in Florida as of August 2026, with employment types broken down into 90% Full Time, and 10% Part Time. Highlights an 100% Remote job distribution.

Oncology Prior Authorization Case Manager, Non-RN - Remote

University of Miami

Miami, FL • On-site, Remote

Full-time

Medical, Dental

Re-posted 29 days ago

University Of Miami rating

7.7

Company rating: 7.7 out of 10

Based on 52 frontline employees who took The Breakroom Quiz

260th of 618 rated colleges and universities

Job description

Current Employees:

If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position, please review this tip sheet.

The University of Miami Health System Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for optimal and efficient patient outcomes, while avoiding treatment delays and authorization denials. They are accountable for a designated patient caseload and provide intervention and coordination to decrease avoidable delays, at all times they provide communication of progress and or determination to the clinical team and or the patient. He/she monitors care and acts as a liaison between patient/family, healthcare personnel, and insurers. Evaluates the needs of the patient, the resources available, and recommends and facilitates for the best outcome to meet ongoing patient needs that encourages compliance with medical advice.

CORE FUNCTIONS:

  • Adhere and perform timely prospective review for services requiring prior authorization as well as timely concurrent review for continuation of care services

  • Follows the authorization process using established criteria as set forth by the payer or clinical guidelines

  • Accurate review of coverage benefits and payer policy limitations to determine appropriateness of requested services

  • Refers to the treatment plan for clinical reviews in accordance with established criteria and guidelines

  • Facilitates communication of denials and or Peer to Peer requests between payers and the healthcare team

  • Identifies potential delays in treatment or inappropriate utilization by reviewing the treatment plan, serves as a resource to provide education regarding payer policies and assists with coordination of alternative treatment options

  • Ensures and Maintains effective communication regarding authorization status and determination to the clinical team and on occasion the patient.

  • Proactive communication with leadership regarding barriers and or potential delays in care Identifies opportunities for expedited requests and prioritizes caseload accordingly

  • Maintains knowledge regarding payer reimbursement policies and clinical guidelines.

  • This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

CORE QUALIFICATIONS:

Education:

Bachelor's degree in relevant field; or equivalent

Experience:

Minimum of 2 years of relevant experience

Oncology - Preferred

Any relevant education, certifications and/or work experience may be considered

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.

Job Status:

Full time

Employee Type:

Staff

What University Of Miami employees say

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About University of Miami

Sourced by ZipRecruiter

The University of Miami, located in the beautiful Coral Gables, Florida, is a comprehensive, private research institution in the United States. Operating within the higher education industry, the institution offers a multitude of degree programs spanning over 180 majors and program through its 12 colleges. The University was founded in 1925 with the mission to disseminate knowledge, transform lives, and change the world - a mission it has held faithfully to this day. Notably, the University of Miami has gained global recognition for its commitment to research and innovation, with over $324 million in research and sponsored project funding awarded annually.

Industry

Colleges, universities, and professional schools

Company size

10,000+ Employees

Headquarters location

Coral Gables, FL, US

Year founded

1925

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