Health Plan Client Experience Lead

Colorado Psychiatric; Colorado; On-site; USD 47,000 - 122,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Other resources

Job summary

CVS Health is seeking a full-time Client and Member Support professional to help streamline health services in the United States. You will perform plan changes, ID card facilitation, reporting, and inbound calls during implementation while also handling invoicing and group terminations.

You will oversee prior authorization, eligibility, and claims issues, with up to 25% travel across the continental United States. Salesforce experience and a Bachelor’s degree are preferred.

Qualifications

• 5+ years of experience in a pharmacy, PBM, and/or insurance setting.
• Ability to travel up to 25% of time within the continental United States.
• Bachelor's degree preferred.

Responsibilities

• Perform and support plan changes.
• Perform ID card facilitation.
• Complete any necessary reporting (scheduled, ad-hoc).
• Conduct inbound phone calls.
• Complete any assigned invoices.
• Perform any assigned group terminations.
• Complete documentation requests.
• Serve as a presence throughout the implementation process.
• Facilitate and participate in external-facing meetings.
• Perform overrides as needed.
• Oversee prior authorization and accessibility processes.
• Oversee resolution of claims issues.
• Perform manual eligibility adds and terminations.
• Service warranties as assigned.

Skills

Pharmacy/PBM/insurance experience

Travel up to 25% (continental US)

Education

High school diploma or GED

Bachelor's degree (preferred)

Tools

Salesforce

Job description

CVS Health is seeking a full-time Client and Member Support professional to help streamline health services in the United States. You will perform plan changes, ID card facilitation, reporting, and inbound calls during implementation while also handling invoicing and group terminations.

You will oversee prior authorization, eligibility, and claims issues, with up to 25% travel across the continental United States. Salesforce experience and a Bachelor’s degree are preferred.