Experienced Inbound/Outbound Queue Associate - Remote Medical Services Coordination for CVS Health

Transforming Healthcare through Compassionate Service At CVS Health, our mission is to bring our heart to every moment of your health. As a leader in the healthcare industry, we're committed to delivering enhanced human-centric health care that's both personal and convenient. Our team is guided by a clear purpose and supported by our Heart At Work Behaviors, which empower us to innovate and make a meaningful difference in the lives of our customers. Job Overview We're seeking an experienced Inbound/Outbound Queue Associate to join our team at Workwarp, a CVS Health company. As an Inbound/Outbound Queue Associate, you'll play a critical role in coordinating medical services, ensuring seamless communication between members, providers, and our healthcare team. This is an exciting opportunity to work remotely and be part of a dynamic team that's shaping the future of healthcare.

Key Responsibilities

• Coordinate medical services, including intake, screening, and referrals to Aetna Better Health
• Respond to inbound calls from members and providers, and make outbound calls to providers to obtain or provide clinical information
• Utilize Aetna systems, such as MedCompass, QNXT, SSA, ProFAX, and ProPAT, to build, research, and enter member information
• Screen requests for appropriate referral to medical services staff and approve services that don't require medical review
• Perform non-medical research, including eligibility verification, COB, and benefits verification
• Maintain accurate and complete documentation, adhering to risk management, regulatory, and accreditation requirements
• Communicate effectively with internal stakeholders, including Aetna Case Managers, Nurses, and Medical Directors
• Protect member confidentiality and adhere to company policies regarding confidentiality

Essential Qualifications

To succeed in this role, you'll need:

• 1-2 years of experience working as a medical assistant, office assistant, or in a clinical/equivalent role
• Residency in Florida
• High School diploma or equivalent GED

Preferred Qualifications

While not required, the following experience will give you a competitive edge:

• 1-2 years of call center experience
• 1-2 years of prior authorization experience

Skills and Competencies

To excel as an Inbound/Outbound Queue Associate, you'll need:

• Excellent communication and interpersonal skills
• Strong analytical and problem-solving skills
• Ability to work in a fast-paced environment, managing multiple tasks and priorities
• Proficiency in using various software applications, including Aetna systems
• Strong attention to detail and organizational skills

Career Growth and Learning Benefits At CVS Health, we're committed to helping you grow and develop your skills. As an Inbound/Outbound Queue Associate, you'll have access to:

• Ongoing training and development programs
• Opportunities for career advancement within the company
• Collaborative and dynamic work environment that fosters innovation and teamwork

Work Environment and Company Culture

As a remote team member, you'll enjoy the flexibility and autonomy to work from home while still being connected to our vibrant company culture. Our employees are self-disciplined, hardworking, curious, trustworthy, humble, and truthful, and we encourage a culture of collaboration and teamwork.

Compensation and Benefits

We offer a competitive salary range of $17.00 - $25.65 per hour, depending on your experience and qualifications. In addition to your base pay, you'll be eligible for a CVS Health bonus, commission, or short-term incentive program. Our comprehensive benefits package includes:

• Medical, dental, and vision benefits
• 401(k) retirement savings plan and Employee Stock Purchase Plan
• Fully-paid term life insurance plan and short-term and long-term disability benefits
• Well-being programs, education assistance, and free development courses
• CVS store discount and discount programs with participating partners
• Paid Time Off (PTO) and paid holidays throughout the calendar year

Join Our Team If you're a motivated and compassionate individual ready to make a difference in the healthcare industry, we encourage you to apply now. We're excited to review your application and discuss this opportunity further. At CVS Health, we're committed to creating a workplace that's inclusive and equitable for all employees. We anticipate the application window for this opening will close on 10/29/2024. Qualified applicants with arrest or conviction records will be consider