Meritain Pharmacy Solutions Clinical CARE Specialist - RN/LVN/LPN

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Exciting New Clinical Role Open with our Meritain Pharmacy Solutions CARE team. Are you a nurse that likes to engage with patients, helping them to navigate this complex healthcare world? Do you enjoy helping members get a fair price for their high-cost specialty medications? Do you like lowering total cost of care for employers? Clinical (nurse) CARE specialists at Meritain Pharmacy Solutions help ensure our people, processes and technology enable our CARE savings strategies to navigate the health care system, and are comfortable responding to employer/ member questions surrounding high-cost specialty medication needs.  

We are looking for a nurse that has multiple years in healthcare, enjoys patient management, has medical claim knowledge, pharmacy knowledge, and also has experience with medication access. Are you wanting to be a true member advocate? If this sounds like you, please apply!

This is fully remote position eligible candidates may live anywhere in the contiguous Unite States.

Duties:

• Collaborate with provider offices to help patients streamline treatments of specialty medications, finding the lowest cost for employers and members
• Comfortable speaking with members regarding specialty medications and administering of medications
• Clinical liaison for member inquiries
• Educating on clinical topics to the organization

Required Qualifications:

• Active, unrestricted Registered Nurse (RN), Licensed Practical Nurse (LPN), or Licensed Vocational Nurse (LVN) license in the state of residence required.
• 4+ years nursing experience
• Minimum 1 year claim processing and claims analysis experience
• Minimum 1 year clinical policy and compliance experience
• Ability to travel up to 10% as needed for meetings

Preferred Qualifications:

• Pharmacy experience – dispensing, managed care space, pharmacy tech experience highly desired
• Managed care or Third Party Administrator experience
• Self-funded employer experience

Education

• Graduate of an accredited nursing program required
• Bachelor’s degree preferred

Pay Range

The typical pay range for this role is:

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.  This position also includes an award target in the company’s equity award program. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.