Scottsdale, Arizona

Job Description
As a Sr. Coordinator within the Medicare D Premium Billing group for Gap Closures, Plan Error Reinstatements, and Good Cause, this individual has shared responsibility over all Good Cause Requests received via email, hard copy mail or through our Resolution Management system. All cases must be looked at and determined Favorable or Unfavorable. Case Notes must be written with strict attention to detail of Who, What, Where and When, Confirming letters based on final outcome of Good Cause Determination must be sent, Reinstatement of member when applicable allowing for Access to Care and final RPC submission, all within the strict confines of CMS guidance and time frames.

The Sr. Coordinator must process extensive additional research to determine if a request is even a Good Cause request and respond. If enough information was not reported from the Care Reps. The call must be pulled, listened to and/or an outbound call could be placed to the member for additional questions. Reports, Metrics and Letters are processed daily within strict timelines.

Outbound call campaigns to our members are coordinated through a third party vendor and files must be confirmed daily for the vendor along with follow up reports on the results of the outbound campaigns. This person will also check all database trackers that help to identify any missed requests, tasks, processes or outbound letters.

The Sr. Coordinator will interact cross-functionally with other internal/ external business partners and vendors as needed must have a high level of understanding for all Medicare Part D processes. This role will often need to communicate with multiple levels within the organization verbally or via written communication. As a Sr. Coordinator, this person is expected to identify any new processes and update all work instructions. Yearly, work instructions are confirmed and checked for accuracy.

Required Qualifications
Knowledge of:
1 or more years Customer Service experience.
1 or more years of experience with Microsoft Office applications either academically or professionally

COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
  • If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
  • If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications
Knowledge of:
Medicare D or other highly regulated government programs is a plus.

High School Diploma or General Equivalent Development (GED)

Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. See Job Description

Scottsdale, Arizona

Continue serving and work with a purpose

As a CVS Health colleague, you'll find career opportunities across the organization and at every stage of your career. More important, your work will have an impactful purpose on someone's life, including your own. Learn more about how you can continue serving on your next mission at CVS Health.

Careers for Veterans and Military Spouses


"The military has an ethos that is grounded in purpose-driven service that’s bigger than the individual. The same holds true for us at CVS Health. You can talk to colleagues in any part of our business and they will be able to articulate our company’s purpose. Working here provides an opportunity for service members and military spouses to continue to serve, just in a civvies."

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