Full-Time

Quality Management Nurse Associate LPN

Posted on 11/21/2024

CVS Pharmacy

CVS Pharmacy

10,001+ employees

Retail pharmacy and healthcare services provider

Healthcare
Consumer Goods

Compensation Overview

$22.4 - $58.4Hourly

+ Bonus + Commission + Short-term Incentive Program

Mid

Company Historically Provides H1B Sponsorship

Remote in USA

Category
Nursing & Allied Health Professionals
Medical, Clinical & Veterinary
Requirements
  • Must have active current and unrestricted LPN/LVN licensure in state of residence
  • 3+ years of clinical experience
  • 3+ years of experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.)
  • 1+ year of Medicare experience
  • Must be able to work Monday through Friday 11am - 7pm eastern
Responsibilities
  • responsible for reviewing and approving all pre-service post-acute denial correspondence
  • collaborating with RNs and Medical Directors on appropriate denial letter language that meets all CMS requirements including member friendly language while meeting TAT metrics
  • Identifies a need for standard denial language and suggests options to close gaps

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, beauty items, and general merchandise. CVS Health also functions as a pharmacy benefits manager, serving over 75 million plan members, and has a senior pharmacy care business that assists more than one million patients each year. This integrated model allows CVS Health to deliver affordable health management solutions, improving access to quality care and health outcomes while aiming to reduce overall healthcare costs. Unlike many competitors, CVS Health combines retail pharmacy services with clinical care and pharmacy benefits management, positioning itself as a significant player in the healthcare sector with a commitment to enhancing people's health.

Company Stage

N/A

Total Funding

N/A

Headquarters

Woonsocket, Rhode Island

Founded

N/A

Growth & Insights
Headcount

6 month growth

-2%

1 year growth

-2%

2 year growth

-2%
Simplify Jobs

Simplify's Take

What believers are saying

  • The availability of updated flu and COVID-19 vaccines at CVS Pharmacy and MinuteClinic locations nationwide positions the company as a key player in public health initiatives.
  • The Health Zones funding and collaboration with local organizations in Fresno highlight CVS Pharmacy's role in improving community health outcomes.
  • The introduction of a new store brand for snacks, beverages, and groceries could attract a broader customer base and increase in-store sales.

What critics are saying

  • The competitive landscape in the retail pharmacy sector is intense, with major players like Walgreens and Rite Aid posing significant challenges.
  • The expansion into grocery and snack products may dilute CVS Pharmacy's brand identity as a healthcare provider.

What makes CVS Pharmacy unique

  • CVS Pharmacy's integration of digital tools for scheduling vaccinations and accepting walk-ins offers a seamless and convenient experience for customers, setting it apart from competitors.
  • The company's Health Zones initiative, which focuses on community health and access to healthy food, demonstrates a commitment to social responsibility that goes beyond traditional pharmacy services.
  • CVS Pharmacy's recent launch of a new store brand for snacks, beverages, and groceries diversifies its product offerings, making it a one-stop shop for consumers.

Help us improve and share your feedback! Did you find this helpful?