Clinical Care Coordination Specialist

3 weeks ago


Tallahassee, Florida, United States CVS Health Full time

At CVS Health, we're committed to delivering enhanced human-centric healthcare for a rapidly changing world.

Our purpose guides our commitment to coordinate, document, and communicate all aspects of the utilization/benefit management program as a Clinical Care Coordination Specialist - Health Services.

Key Responsibilities
  • Utilize clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services/benefits for members.
  • Gather clinical information and apply the appropriate clinical criteria/guideline, policy, procedure, and clinical judgment to render coverage determination/recommendation along the continuum of care.
  • Communicate with providers and other parties to facilitate care/treatment and identify members for referral opportunities to integrate with other products, services, and/or programs.
  • Consult and lend expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.
Requirements
  • Active, current, and unrestricted RN licensure in the state of residence.
  • 3+ years of experience as a Registered Nurse.
  • 1+ years of clinical experience in an acute or post-acute setting.
  • Ability to work Monday - Friday 8:00am-5pm in the time zone of residence with late night rotation 10:30 - 7pm EST or CST.
Preferred Qualifications
  • Experience working in ER, Med/Surg, and/or Critical care setting.
  • Managed Care experience.
  • Utilization review experience.
  • Experience working with MS office applications such as Teams, Outlook, Excel, and Word.
Estimated Salary Range

The typical pay range for this role is $56.14 per hour or $116,241 per year. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors, including experience, education, geography, and other relevant factors.

This position is eligible for a CVS Health bonus, commission, or short-term incentive program in addition to the base pay range listed above.

Benefits

At CVS Health, we offer a comprehensive benefits package that includes medical, dental, and vision benefits, 401(k) retirement savings plan, and an Employee Stock Purchase Plan. We also provide a fully-paid term life insurance plan, short-term and long-term disability benefits, and numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.

We also offer Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. The number of paid holidays, sick time, and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit our website.



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