• Ability to work Silverscript PDP cases (Including MMR) independently
• Ability to work Aetna MAPD cases (including MMR) independently
• Serves as CTM Mentor on an as needed basis
• CTM Team SPOC
• CTM Special Projects
• Night Check
• Able to perform HPMS Download / Triage
• Progress from Full Case Review to Expedited Case Review
• Production - Aetna close 1.5 cases per day / Silverscript close 1.8 cases per day
The typical pay range for this role is:
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
CTM Senior Coordinator Qualifications
Knowledge of all MAPD CTM systems and products
Stretch Assignments and Department Responsibilities:
Has progressed from Expedited Case Review to Independent Case Review
Serves as CTM Case Reviewer
Serves as SPOC for high-touch members / providers
Abiliy to works Allina Health cases
Ability to works California IPA cases
Ability to work Escalated Cases and participates in the Escalation workgroup
Excellent Time management/Organization Mentor for peers
Excellent oral and written communication skills
Production – consistently closes 1.8 cases per day
• Facilitates Team Huddle
• Leads / Participates in Team Building Initiatives
• Various Presentation / Facilitation assignments
• General Medicare knowledge
• Prior experience with CTMs and/or Center for Medicaid and Medicare Services (CMS)
• Claim processing knowledge
• Ability to work flexible hours, some weekends and holidays. Overtime may be required during busy times of year.
Bachelors or equivalent work experience
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
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