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CVS Health Consultant Clinical Client Ops in Irving, Texas

Job Description

The Clinical Client Operations - Consultant will be responsible for analyzing Client's specialty benefit requests and inputting data into RxClaim to maintain specialty benefits (pricing, co-pays, grace fills, etc.) and building of new Specialty benefits for clients. The Consultant's duties will emphasize data analysis and review of client documentation to determine client intent for their specialty benefit. Analysis will be completed using RxClaim and analytical tools (i.e. MS Excel and MS Access) in support of specialty builds and maintenance. Other duties will include RxClaim query, data analysis, manual updates to RxClaim, testing changes using EZ- Test and macros and reviewing test claims for accuracy. The Consultant will also use SalesForce to track work and monitor TAT. The Consultant will confirm client intent when necessary and ensure complete client documentation is included with all request.

Required Qualifications

1 year prior work experience in Microsoft applications, RxClaim Coding, RxClaim Query/EZ Query

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

SalesForce.comCertified Pharmacy Technician experience


High School Diploma or GED requiredBachelor Degree preferred

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.