UMNC (Prior Authorization WFH anywhere in the US)
CVS Health, a leading healthcare innovation company, is looking for dedicated individuals to join our team as UMNC (Prior Authorization) specialists. This position offers the flexibility to work from home, anywhere in the United States. In this role, you will be responsible for reviewing medical requests and determining coverage, ensuring that our members receive the highest quality care. This is an excellent opportunity to contribute to healthcare initiatives while advancing your career with CVS Health.
Job Details
| Job Title | UMNC (Prior Authorization) |
|---|---|
| Location | Work From Home (Anywhere in the US) |
| Job Type | Full-time, Permanent |
| Schedule | Flexible hours, 40 hours per week |
| Salary | Competitive pay (based on experience) |
| Department | Medical Management |
| Reports To | UMNC Manager or Supervisor |
| Experience Level | 2+ years of healthcare or prior authorization experience required |
| Education | High School Diploma required; Associate’s or Bachelor’s Degree preferred |
Responsibilities
- Review and process prior authorization requests in accordance with clinical guidelines.
- Collaborate with healthcare providers to ensure timely and accurate processing of medical requests.
- Maintain accurate documentation of all authorization decisions.
- Provide exceptional customer service to members and providers.
- Ensure compliance with state and federal regulations governing healthcare.
- Work with the team to resolve discrepancies in authorizations.
- Contribute to the continuous improvement of prior authorization processes.
- Stay up-to-date with healthcare trends, policies, and technologies.
Requirements
- Minimum of 2 years of experience in healthcare, medical insurance, or prior authorization.
- Strong understanding of clinical terminology and healthcare procedures.
- Excellent written and verbal communication skills.
- High attention to detail and strong organizational skills.
- Proficiency in Microsoft Office and healthcare management software.
- Ability to maintain HIPAA compliance and confidentiality.
- Strong problem-solving and critical thinking abilities.
- Ability to work both independently and as part of a remote team.
Benefits
- Competitive salary with performance-based incentives.
- Flexible work-from-home options.
- Comprehensive health insurance for you and your family.
- Paid time off (PTO) and paid holiday leave.
- 401(k) retirement plan with company match.
- Tuition reimbursement for continued education.
- Employee Assistance Program (EAP) for personal and professional support.
- Career development opportunities and room for advancement.
Health Insurance
- Comprehensive medical, dental, and vision coverage.
- Prescription drug benefits.
- Preventive care services at no additional cost.
- Mental health and wellness programs.
Why Join Us?
At CVS Health, we are committed to helping people on their path to better health. By joining our team, you'll have the opportunity to make a meaningful impact on healthcare delivery, while advancing your career in a supportive and innovative environment. We foster a culture of diversity, inclusion, and professional growth, where every employee has the opportunity to succeed.
How to Apply
Interested candidates should submit their resumes via our career portal on the CVS Health website. Please include a summary of your relevant experience and qualifications. Qualified applicants will be contacted for an interview.
Take the next step in your career with CVS Health and help us improve healthcare for millions!