Care Coordination Specialist – Transplant & Medical Services

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

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is hiring for a role supporting the National Medical Excellence Program with inbound calls from providers and members. You will use multiple Aetna systems to build and verify member data and support non-medical research like eligibility and benefits verification.

Responsibilities include processing referrals, coordinating with clinical teams, and initiating transplant authorizations while ensuring confidentiality and regulatory compliance.

Qualifications

• 2+ years’ experience as a medical assistant or equivalent clinical role.
• Proficient with Microsoft Excel and basic office software.
• Ability to communicate with diverse populations effectively.
• Strong teamwork and collaboration in a patient-centered environment.
• Flexibility to work independently as needed.

Responsibilities

• Handle intake of calls from providers or members.
• Use Aetna systems (MedCompass, HRP, ASD, CEC, ATV) to build and enter member data.
• Conduct non‑medical research including eligibility and benefits verification.
• Record required information accurately and meet regulatory standards.
• Process referrals and outreach calls via telephone, fax, or EDI.
• Collaborate with clinical, claims, and contacting staff.
• Communicate with transplant financial coordinator and transplant center staff.
• Initiate authorizations for kidney transplants per unit process.
• Communicate transplant services details to members or providers.
• Create shell cases for transplant, cellular therapy, and gene therapy requests.

Skills

Medical software communication

Call center experience

Team collaboration

Independent work

Diversity communication

Education

High School Diploma or GED

Associate Degree Preferred

Tools

Microsoft Excel

Job description

CVS Health is hiring for a role supporting the National Medical Excellence Program with inbound calls from providers and members. You will use multiple Aetna systems to build and verify member data and support non-medical research like eligibility and benefits verification.

Responsibilities include processing referrals, coordinating with clinical teams, and initiating transplant authorizations while ensuring confidentiality and regulatory compliance.