Care Coordination Pro – Health Plan & Transplant Support

CVS Health; Ohio; Remote; USD 25,000 - 49,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health in the United States is seeking a coordinator for the National Medical Excellence Program to handle inbound calls from the phone queue and support transplant services.

Responsibilities include intake of calls, use of MedCompass, HRP, ASD, CEC, and ATV; eligibility and benefits verification; data entry; collaboration with clinical teams; and processing authorizations for kidney transplants while protecting patient confidentiality.

Qualifications

• 2+ years’ experience in medical assistance or related clinical role.
• Proficiency with Microsoft Office, especially Excel.
• Ability to communicate with diverse populations and work in a team.

Responsibilities

• Handle intake of calls from providers or members.
• Enter and research member information in applicable systems.
• Verify eligibility, COB, and benefits for members.
• Maintain documentation in compliance with risk, regulatory, and accreditation standards.
• Process referrals and outreach calls; enter data as needed.
• Collaborate with clinical teams, medical directors, claims, and staff.
• Coordinate transplant-related communications and authorizations.
• Protect confidentiality of member information.

Skills

Excel

Team collaboration

Communication

Education

High School Diploma or equivalent

Associate Degree

Tools

MedCompass

HRP

ASD

CEC

ATV

Job description

CVS Health in the United States is seeking a coordinator for the National Medical Excellence Program to handle inbound calls from the phone queue and support transplant services.

Responsibilities include intake of calls, use of MedCompass, HRP, ASD, CEC, and ATV; eligibility and benefits verification; data entry; collaboration with clinical teams; and processing authorizations for kidney transplants while protecting patient confidentiality.