CVS Health

Pharmacist

• Support the pharmacy team in delivering operational and service excellence within the store
• Assist patients and customers as a first point of contact
• Follow company SOPs and pharmacy workflow procedures across production, pick-up, drive-thru, and drop-off workstations
• Ensure prescriptions are filled promptly, safely, and accurately
• Provide empathetic and personalized patient service and resolve or escalate patient problems
• Offer immunizations and other services at the register and over the phone where permitted
• Complete inventory activities including medication deliveries, cycle counts, returns-to-stocks, and waiting-bin inventories
• Expand clinical and technical knowledge and contribute to a high-performing team
• Travel voluntarily to market stores to work shifts as needed
• Comply with laws, regulations, professional standards, ethical principles, and CVS policies
• Deliver additional healthcare services such as immunizations and point-of-care testing where allowable and properly trained
• Support technician immunization duties where permissible, including vaccine preparation and administration, patient education, adverse-reaction monitoring, documentation, and vaccine-supply management
• Perform other tasks as directed by a Supervisor or Manager

Pharmacy Technician

• Support the pharmacy team in delivering operational and service excellence
• Assist patients and customers as a first point of contact
• Follow company SOPs and pharmacy workflow procedures across production, pick-up, drive-thru, and drop-off
• Ensure prescriptions are filled promptly, safely, and accurately
• Provide empathetic patient service, solve or escalate patient problems, and offer immunizations and other services
• Complete basic inventory activities, including medication deliveries, cycle counts, returns-to-stocks, and waiting-bin inventories
• Expand clinical and technical knowledge and contribute to a high-performing team
• Remain flexible for scheduling and business needs and voluntarily work shifts at other market stores
• Comply with applicable laws, regulations, professional standards, ethical principles, and CVS policies
• Deliver additional healthcare services such as immunizations, point-of-care testing, and offsite clinics where legally permitted and properly trained
• When permitted, obtain Technician Immunizer status, prepare and administer vaccines, educate patients, monitor adverse reactions, document patient information, and manage vaccine supplies
• Perform additional tasks as directed by the Supervisor or Manager

• Collaborate with technicians and prior authorization team members to process referrals
• Answer clinical questions and collect clinical/medical data for clinical assessments and reviews
• Evaluate and review prior authorization requests and render coverage determinations based on clinical criteria and plan design
• Verify insurance coverage and eligibility
• Interpret clinical guideline criteria and consult physicians and other healthcare providers
• Apply clinical knowledge and resources while complying with department protocols
• Convey case decisions promptly to healthcare providers, health plans/employers, patients, and other healthcare professionals
• Perform inbound and outbound calls to facilitate prior authorization requests, answer inquiries, and resolve escalations
• Maintain communication among CVS Caremark, health plan, and employer group staff
• Maintain professional and technical knowledge of drug and disease states for Specialty and Non-Specialty Pharmacy programs
• Complete related projects and duties, attend training and development meetings, and provide on-call and after-hours pharmacist availability as needed

Clinical Pharmacist – Prior Authorization

Operations

• Handle and process benefits claims submitted by healthcare providers
• Determine benefits eligibility and coverage based on insurance plans and policy guidelines
• Assess claims for accuracy, medical necessity, coding compliance, and documentation requirements
• Document claim information and assign appropriate codes, modifiers, and data elements
• Conduct reviews and investigations requiring additional scrutiny or validation
• Communicate with healthcare providers, patients, and stakeholders to resolve claim discrepancies
• Ensure claims processing complies with regulatory requirements, industry standards, and company policies
• Provide regular, timely feedback and participate in formal performance reviews and team development
• Analyze claims data and generate reports identifying trends, patterns, and improvement areas
• Review and adjudicate claims according to processing guidelines
• Apply medical necessity guidelines, verify eligibility, identify discrepancies, and apply cost containment measures
• Review referrals and submissions and apply coding, member identification, and provider selection processes
• Analyze and process rework claims that cannot be auto-adjudicated
• Manage route lists and queues according to operational guidelines
• Use applicable system functions to ensure accurate and timely claim processing

Claim Benefit Specialist – Commercial Operations

• Support the pharmacy team in delivering operational and service excellence
• Serve as an initial point of contact for patients and customers
• Follow company SOPs and pharmacy workflow procedures across production, pickup, drive-thru, and drop-off workstations
• Ensure prescriptions are filled promptly, safely, and accurately
• Provide empathetic and personalized patient service and resolve or escalate patient problems
• Offer immunizations and other patient health services where permitted by law and supported by training and certification
• Complete basic inventory activities, including putting away medication deliveries, cycle counts, returns-to-stocks, and waiting-bin inventories
• Contribute to a high-performing, safe, inclusive, and engaging team
• Expand clinical and technical knowledge and respond to feedback
• Maintain flexibility for scheduling and business needs, including voluntarily traveling to market stores for shifts
• Comply with applicable laws, regulations, professional standards, ethical principles, and CVS policies
• Support immunization activities where permitted, including completing immunizer licensure and training, educating patients, monitoring adverse reactions, documenting patient information, and managing vaccine supplies
• Complete required company training and registration, licensing, and certification requirements

Representative

• Work in a high-volume, production-oriented, time-sensitive Call Center environment
• Assist customers by phone to provide Prescription Records and status updates on requests
• Process prescription records in a data-entry system in response to fax, mail, and email requests from regulatory agencies, courts, law enforcement, attorneys, insurance agencies, patients, and other third parties
• Maintain the strictest level of confidentiality when handling Protected Health Information
• Comply with regulatory and subpoena demands in accordance with state and federal HIPAA/Privacy requirements

Rx Records, Representative II

• Handle and process Benefits claims submitted by healthcare providers
• Determine eligibility and coverage based on insurance plans and policy guidelines
• Assess claims for accuracy, coding compliance, medical necessity, and documentation requirements
• Document claim information, codes, modifiers, and other data elements in company systems
• Conduct reviews and investigations requiring additional scrutiny or validation
• Communicate with healthcare providers, patients, and stakeholders to resolve discrepancies
• Ensure claims processing complies with regulatory requirements, industry standards, and company policies
• Provide feedback and participate in formal performance reviews to support service delivery and team development
• Analyze claims data and generate reports identifying trends and improvement areas
• Review and adjudicate claims according to processing guidelines
• Apply medical necessity guidelines, verify eligibility, identify discrepancies, and apply cost containment measures
• Review claims or referrals and apply coding, member identification, provider selection, and pre-coding processes
• Analyze and process rework claims that cannot be auto-adjudicated
• Manage route lists and queues according to operational guidelines
• Use applicable system functions to ensure accurate and timely claim processing
• Complete 12–20 weeks of virtual training from 8:00–4:30 EST

Director

• Define and execute the technology strategy and multi-year roadmap for Corporate Affairs, including Legal, Compliance, and Corporate Security
• Serve as a strategic partner to business leadership, aligning technology solutions to legal, compliance, and security priorities
• Lead and develop Senior Managers and their teams, ensuring performance, accountability, and organizational growth
• Own the end-to-end application portfolio, including design, delivery, operations, and modernization of platforms
• Champion AI, automation, and advanced analytics solutions
• Ensure governance, risk management, and compliance, including audit readiness and adherence to enterprise policies such as SOX and security standards
• Drive delivery excellence across cross-functional initiatives
• Manage vendor relationships, contracts, and financials, optimizing portfolio value

Lead Director – Corporate Affairs Technology

Project Manager

• Direct all aspects of customer benefit plan implementation for self-funded new business clients.
• Partner with internal and external stakeholders to identify and address critical implementation issues.
• Act as the single point of contact for benefit plan implementation.
• Mediate and coordinate resolution of project deliverables and implementation-related tasks.
• Develop and execute implementation strategies aligned with customer expectations.
• Ensure strategies are administered according to performance guarantee arrangements.
• Engage team members to complete their responsibilities.
• Evaluate customer-requested exceptions and develop alternatives that meet client needs while minimizing operational and system impact.
• Solicit and assess customer feedback to improve implementation quality.

Senior Analyst, Project Management

Account Manager

• Develop basic account plans and strategies to support customer satisfaction, retention, and business growth
• Analyze customer data, performance metrics, and service trends to identify opportunities for improvement and support account management initiatives
• Build and maintain working relationships with customers, brokers, and internal business partners
• Participate in customer meetings and communications to support account management activities and address customer needs
• Coordinate eligibility and enrollment activities, including site additions, urgent enrollments, digital ID card requests, and member eligibility verification
• Review benefit grids, plan documents, Summary of Benefits and Coverage materials, and other customer-facing documents for accuracy and completeness
• Support renewals through grid review, rate validation, benefit comparisons, documentation review, and deliverable coordination
• Assist with billing, commission, and other account-related inquiries and issue resolution
• Research customer, broker, and member issues, manage escalations, and coordinate timely resolution
• Maintain customer records, activities, service requests, and account updates in Salesforce
• Assist with implementation, renewal, and account management projects by tracking tasks, timelines, documentation, and action items
• Contribute to team meetings, process improvement initiatives, and collaborative projects

Analyst, Account Manager

General

• Provide in-home health evaluations in members’ residences
• Conduct approximately 45-minute visits including medication and medical history review and physical evaluation
• Perform additional diagnostic tests when ordered by the health plan, including diabetic eye exams and spirometry
• Use an iPad and clinical workflow for each evaluation
• Build trusted relationships and help improve health outcomes
• Travel locally and within licensed states as needed
• Conduct virtual visits as needed
• Provide Signify Health services, including Diagnostic & Preventive Services such as spirometry, DEE and bone density screening

In Home NP/PA – Full Time

• Support the pharmacy team in delivering operational and service excellence
• Serve as an initial point of contact for patients and customers
• Follow company SOPs and pharmacy workflow procedures across production, pick-up, drive-thru, and drop-off workstations
• Fulfill prescriptions promptly, safely, and accurately
• Provide empathetic and personalized patient service in person and over the phone
• Offer immunizations and other services at the register and over the phone, where permitted
• Solve or escalate patient problems
• Complete inventory activities including medication deliveries, cycle counts, returns-to-stocks, and waiting-bin inventories
• Expand clinical and technical knowledge and respond to feedback
• Travel voluntarily to other stores in the market to work shifts as needed
• Comply with federal, state, and local laws, regulations, professional standards, ethical principles, and CVS policies
• Support additional health care services such as immunizations, point-of-care testing, and offsite clinics where allowed and trained
• Complete licensure and training requirements for Technician Immunizer status where applicable
• Educate patients about vaccines and refer vaccination questions to the pharmacist
• Monitor and respond to adverse reactions and report events
• Review, collect, track, and document patient information
• Monitor and manage vaccine supplies
• Perform additional tasks assigned by the Supervisor or Manager

• Support the pharmacy team in delivering operational and service excellence within the store
• Assist patients and customers as a first point of contact and deliver an exceptional experience
• Follow company SOPs and pharmacy workflow procedures across production, pick-up, drive-thru, and drop-off workstations
• Ensure prescriptions are filled promptly, safely, and accurately
• Provide compassionate patient service, solve or escalate patient problems, and offer immunizations and other services
• Complete basic inventory activities, including putting away medication deliveries, cycle counts, returns-to-stocks, and waiting-bin inventories
• Contribute to a high-performing, safe, inclusive, and engaging team
• Travel voluntarily to other stores in the market to work shifts as needed
• Comply with applicable laws, regulations, professional standards, ethical principles, and CVS policies
• Deliver additional healthcare services such as immunizations, point-of-care testing, and offsite clinic staffing where permitted
• Obtain Technician Immunizer status where applicable and complete related training and licensure requirements
• Educate patients about vaccines and refer vaccination questions to the Pharmacist-on-duty
• Monitor and respond to adverse reactions and report events as required
• Review and collect patient information and document applicable patients
• Monitor and manage vaccine supplies
• Perform additional tasks as directed by a Supervisor or Manager

• Process prior authorization requests received by phone, fax, or electronically
• Use computer resources, existing criteria, and medication guidelines to perform clinical research supporting prior authorization reviews
• Complete prior authorization approvals and denials that are due to expire
• Maintain complete, timely, and accurate documentation
• Review potential prior authorization denial language to ensure NCQA requirements are met
• Follow prior authorization workflows, policies, and procedures
• Answer high-volume prior authorization inquiry calls from provider offices, pharmacies, and internal partners
• Communicate prior authorization status or decisions using multiple computer resources
• Balance productivity, quality, and timeliness of work
• Participate in required training, continuing education, and team or departmental meetings

Pharmacy Technician – Prior Authorization

• Provide In-Home Health Evaluations in members’ homes
• Conduct approximately 45-minute visits
• Engage one-on-one with members and answer health questions
• Review medications and medical history
• Perform physical evaluations
• Conduct additional diagnostic tests when ordered by the health plan, including diabetic eye exams and spirometry
• Use an iPad and clinical workflow for each evaluation
• Build trusted relationships and improve health outcomes
• Visit people nationwide to connect them with appropriate care
• Conduct virtual visits as needed
• Provide Diagnostic & Preventive Services, including spirometry, diabetic eye exams and bone density screening