Davenport, FL · Remote
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior Authorizations, Coordination with PCP and skilled providers, Condition management information ...
Davenport, FL · Remote
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior Authorizations, Coordination with PCP and skilled providers, Condition management information ...
Brandon, FL · Remote
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior Authorizations, Coordination with PCP and skilled providers, Condition management information ...
Brandon, FL · Remote
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior Authorizations, Coordination with PCP and skilled providers, Condition management information ...
Lutz, FL · Remote
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior Authorizations, Coordination with PCP and skilled providers, Condition management information ...
Lutz, FL · Remote
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior Authorizations, Coordination with PCP and skilled providers, Condition management information ...
Doral, FL · On-site
$21.10 - $40.90/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior Authorizations, Coordination with PCP and skilled providers, Condition management information ...
Doral, FL · On-site
$21.10 - $40.90/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior Authorizations, Coordination with PCP and skilled providers, Condition management information ...
Bartow, FL · Remote
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior Authorizations, Coordination with PCP and skilled providers, Condition management information ...
Bartow, FL · Remote
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior Authorizations, Coordination with PCP and skilled providers, Condition management information ...
Columbus, OH · On-site
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Columbus, OH · On-site
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Fayetteville, NC · On-site
$54K - $116K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Fayetteville, NC · On-site
$54K - $116K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Lexington, KY · On-site
$54K - $116K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Lexington, KY · On-site
$54K - $116K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Fayetteville, NC · On-site
$54K - $116K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Fayetteville, NC · On-site
$54K - $116K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
$54K - $116K/yr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
$54K - $116K/yr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Greensboro, NC · On-site
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Greensboro, NC · On-site
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Richmond, VA · On-site
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Richmond, VA · On-site
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Fort Wayne, IN · On-site
$54K - $116K/yr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Fort Wayne, IN · On-site
$54K - $116K/yr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Decatur, GA · On-site
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Decatur, GA · On-site
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
$60K - $129K/yr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
$60K - $129K/yr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Kansas City, MO · On-site
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Kansas City, MO · On-site
$60K - $129K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
$54K - $116K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
$54K - $116K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
$54K - $116K/yr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
$54K - $116K/yr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
$72K - $155K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
$72K - $155K/yr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... prior authorizations. * Conduct thorough and accurate reviews of patient medications and update as ...
Tampa, FL · On-site
$21.10 - $40.90/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior Authorizations, Coordination with PCP and skilled providers, Condition management information ...
Tampa, FL · On-site
$21.10 - $40.90/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Prior Authorizations, Coordination with PCP and skilled providers, Condition management information ...
$13.70 - $15.38
6% of jobs
$15.38 - $17.07
14% of jobs
$17.49 is the 25th percentile. Wages below this are outliers.
$17.07 - $18.75
20% of jobs
The median wage is $19.69 / hr.
$18.75 - $20.43
18% of jobs
$20.43 - $22.12
16% of jobs
$22.31 is the 75th percentile. Wages above this are outliers.
$22.12 - $23.80
12% of jobs
$23.80 - $25.48
7% of jobs
$25.48 - $27.16
5% of jobs
$27.16 - $28.85
2% of jobs
$28.85 - $30.53
0% of jobs
$30.53 - $32.21
0% of jobs
$13
$20
$32
To thrive as a CVS Prior Authorization specialist, you need a solid understanding of pharmacy and medical terminology, insurance verification processes, and prior authorization protocols, often supported by a certificate or associate degree in pharmacy technology or healthcare administration. Familiarity with pharmacy benefit management software, electronic prior authorization (ePA) platforms, and insurance portals is highly beneficial. Excellent attention to detail, strong communication, and problem-solving skills help you collaborate with healthcare providers and insurers efficiently. These skills ensure timely and accurate processing of authorization requests, minimizing patient delays and supporting optimal care delivery.
A CVS Prior Authorization job involves reviewing prescription medication requests to determine if they meet insurance and regulatory requirements. Employees in this role work with healthcare providers, pharmacists, and insurance companies to approve or deny medication requests based on coverage policies. Responsibilities may include verifying patient information, processing requests, and ensuring timely communication to avoid treatment delays. Strong attention to detail, knowledge of medical terminology, and customer service skills are essential for success in this position.
CVS Prior Authorization specialists often encounter challenges such as managing high volumes of requests, navigating complex insurance policies, and handling time-sensitive authorizations. To succeed, it’s important to develop a deep familiarity with pharmacy benefit guidelines and maintain up-to-date knowledge on insurer requirements. Good organizational habits and the ability to work both independently and as part of a team will help you handle workload fluctuations and ensure prompt service. Staying proactive in communication with prescribers and insurance representatives will also help you resolve issues efficiently and improve patient outcomes.
Davenport, FL • Remote
$60K - $129K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 19 days ago
5.8
Based on 4,233 frontline employees who took The Breakroom Quiz
78th of 99 rated pharmacies
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
Position Summary
This is a fulltime remote role with 50-75% travel required for face-to-face visits with members in Polk, Hillsborough, Highlands, Hardee, Manatee Counties. Schedule is Monday-Friday, 8:00am-5:00pm, standard business hours.
We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Clinical Case Management to join our Case Management team. This opportunity offers a competitive salary and full benefits. Our organization promotes autonomy through a Monday-Friday working schedule, paid holidays, and flexibility as you coordinate the care of your members. Clinical Case Management is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Clinical Case Management will effectively manage a caseload that includes supportive and medically complex members. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration. Clinical Case Management will determine appropriate services and supports due to member's health needs; including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports.
Required Qualifications
Preferred Qualifications
Education
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$60,522.00 - $129,615.00This 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.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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Health care and social assistance and retail
10,000+ Employees
Woonsocket, RI, US
