Expanding Prior Authorizations; Decreasing Costs at CVS Health

Pharmacy Benefits Management (PBM) is a complex business model with moving parts, like government regulations and Medicare, and sitting on the other side of all the complexity are patients needing access to medications and care. With little room for error and lots of room for innovation, CVS Health’s PBM Product and Process Innovation team tackles each complex business challenge with enviable veracity, their tenacity in problem solving only rivaled by their respect and care for patients.

We’re sharing a behind-the-scenes look at how they approach and solve some of the toughest challenges.

“Our projects usually start with big questions,” Christie Callahan, a senior director in Strategic Process Innovation, said.

Callahan and Hillary Moore, Strategic Process Innovation Advisor at CVS Health, partnered to improve quality and efficiency of coverage determination in Medicare, which is a highly regulated segment. Prior authorizations ensure therapies are appropriate for the patients’ conditions, eliminating abuse and minimizing costs for those people who do need medications.

“We wanted to make this a more powerful tool to control costs while still serving our members in the most consistent, accurate, and timely way,” Callahan said.

The team started asking important questions: How do we make prior authorizations more efficient? How do we make our timelines even tighter for our members so they get decisions faster? And how do we make it more cost effective?

Knowing prior authorization resolution is a highly manual process–some cases get reviewed as many as seven times–Callahan and Moore knew there was opportunity to automate pieces of the process. They started by watching prior authorizations flow through the systems.

“We had to figure out what systems they were using, how processing a case worked, where people got stuck,” Callahan said.

From there, the data did the talking and propelled Callahan and Moore to create a road map for 2016 to tackle key areas, such as times pharmacists needed more information from physicians to complete prescriptions.

The process uncovered best time of day to call physicians, who should make the calls, and even the type of written communication that works best for physicians should they be unreachable by phone.

“We needed to come up with an automated solution to get information back from those prescribers and use it to efficiently process more cases for members,” Moore said.

The successful implementation of the tech solution they created reduced costs two-fold: they reduced number of times a case was reviewed while increasing the effectiveness of the review, all while staying compliant with CMS.

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CVS Health is growing its PBM Process and Product teams; are you ready to solve some of health care’s toughest challenges? You can see all of our available Process and Product Innovation job opportunities on our career site.

CVS Health Interns Lead with Heart

Andre Jankowski started his career at CVS Health by interning with the company in 2016 as a summer intern working in the Inventory department.

After graduating Bryant University, with a Supply Chain Management and Psychology major, in 2017 Andre joined full-time and is now working as a Senior Consultant in Inventory Operations.

What excites him about working for CVS Health is that there are “so many different people working together to support CVS Health’s purpose: to help people on the path to better health.” He has created a special bond with his teammates, making CVS Health feel like his home away from home. Being surrounded by a supportive and diverse community has helped Andre grow within the company and keeps him motivated.

According to Andre, there is no typical day at CVS Health, which he admires. He comes into work every day open-minded and curious what the day will bring to him because his managers are assigning him projects with his team even if he does not have a background in what the project is. His managers’ faith in him keeps Andre motivated and energized to come into work every day. Also, the way in which shoppers purchase items and their experience is consistently changing, and in Andre’s role, he gets to be a part of that and being a part of CVS Health in general.

Being a recent college graduate, Andre has several career goals for his future to work on, which includes “learning the various parts of the supply chain through hands on work experience, I would like to understand how top companies like CVS Health, ranked #7 on the Fortune 500 list, can move the amount of product they do in the way that they do. Once I understand many different aspects of the supply chain, I would like to step out of the corporate world and consult for small companies doing process optimization and helping them to understand how supply chains work.”

When Andre thinks of what “leading with heart” means to him, he says, “To lead with heart is to understand that everyone is human, we all have parents or loved ones, maybe children and best friends. When we are making decisions that are going to affect people in the world we need to keep in mind that we are all human and we need to look out for one another!”

To learn more about an internship with CVS Health, visit us on our career site at jobs.cvshealth.com/internships or follow us on social media

RxCrossroads Hiring Event Louisville, KY August 23rd

RxCrossroads, a wholly owned subsidiary of CVS Health, is hosting a hiring event for Case Managers in Louisville, KY!

RxCrossroads Specialty Solutions, a division of Omnicare Inc., is a wholly owned subsidiary of the CVSHealth Corporation, whom provides tailored services to the biotechnology and pharmaceutical industries. Its partner programs are customized to meet the unique needs of each individual brand through an integrated model that provides comprehensive patient services and improves product access, affordability, and adherence. RxCrossroads is also the leading provider of logistics services for plasma and other complicated therapies as well as handling large levels of consigned pharmaceutical inventory used in its patient-specific free drug distribution pharmacy distribution program

POSITIONS AVAILABLE:

Case Managers

Customer Intake Specialists

Please apply online ahead of the hiring event and bring 2 copies of your resume to the event.

 

You are officially invited!

Date: Wednesday, August 23, 2017

Time:  10:00am – 3:00pm

Where: 1901 Eastpoint Parkway, Louisville, KY 40223

What to expect:

You’ll have the opportunity to meet with our recruiter which you might not be able to access any other way. To help you make the most of your time with us, we’ve pulled together a few tips for attending a CVS Health hiring event.

Before the event you should…

  1. Learn more about CVS Health.
  2. Review the jobs we have available in this location.
  3. Update your resume.
  4. Review the location and make sure you know your way to our office.

During the event you should…

  1. Dress professionally.
  2. Bring a few copies of your resume and a pen and paper for taking notes.
  3. Practice your introduction, including your name and career interests and state the type of position in which you are interested.
  4. Be prepared to ask specific questions like skills necessary, benefits, training and requirements.
  5. Remember to use good eye contact and a firm handshake.
  6. Ask for business cards from each person you meet and understand next steps.

We look forward to meeting you and discussing our available opportunities in Louisville!

Backpack to Briefcase; University Students Gain Experience During CVS Health’s Summer Intern Program 2017

This summer, in 2017, we had a successful outcome of the internship program, here at CVS Health, in our corporate offices. With 72 interns located in 6 different states across the U.S., the students in our master’s/MBA program and undergraduate program have had vast opportunities in their departments to learn about the company and gain the experience they will need when applying for a full-time position.

Meet our interns:


Rafael Rodriguez is an undergraduate student at Syracuse University, studying supply chain management and marketing and working in the Woonsocket distribution center this summer as a Distribution Center Leadership Intern. What Rafael likes most about interning at CVS Health is how his supervisors had set him up to succeed by providing him the resources and tools that he needs to help him with his project. Rafael can apply his knowledge from his classes at college to his internship. When Rafael tells his friends and family about working for CVS Health, he says, “I tell them how much I am learning from a professional standpoint and the perks of working for CVS like my discount card, my office, and how great the team I am working with is.”


Kaina Chen is a Pharmacy Product Development Intern this summer and is an undergraduate student at Dartmouth College, studying chemistry and government. When deciding where to intern, Kaina loved CVS Health because of her interest in health care, as well as the people who had a great influence on her during the interview process. Hearing about current employees’ real-world experiences with the company drew Kaina to the position she has now at CVS Health in the undergraduate internship program. Kaina is proud to share that her “experience in the product development group, so far, has been consistently engaging, and I appreciate everyone who is so willing to give me insights on the day-to-day operations. It is exciting to be constantly surrounded by individuals who are extremely perceptive about the business environment and are constantly thinking a dozen steps ahead.”


Matt Muron is working as an Inventory Intern this summer while getting his MBA at Indiana State University with a concentration in business analytics, and supply chain management with a minor in finance. While searching for an MBA internship program, he “found CVS to be a company that genuinely lives out its purpose of creating a better, healthier world; doing so not only as part of its corporate social responsibility role, but also, as a direct means of achieving its mission”. What excites Matt about working at CVS Health is how the company touches so many people in a positive way and how, no matter what department you work in, you make an impact on the company, as well as on the customers that shop in our locations and use our pharmacy. Matt loves the fun and relaxed work environment as well as the friendliness of everyone he comes across at work. He advises future interns to “keep an open mind about your career possibilities” because of the availability of many different opportunities and departments at CVS Health.


Trent Tolbert is an MBA student and an Inventory Analyst Rx Returns Intern here at CVS Health. Trent attended the undergraduate business school at Dartmouth College, obtained his master’s in management studies at Duke University, and is currently attending Emory University to get an MBA with a concentration in finance. Trent’s project this summer is “to calculate our ‘Waste Floor,’ the unavoidable systematic risk inherent in our industry and current business practices.” Trent loves working for CVS Health because of the company’s moral integrity and the great decisions CVS Health continues to make to help customers. As an MBA intern at CVS Health, Trent appreciates “seeing the direct impact of my work. My project has tremendous scope and freedom so knowing that my project’s output could affect ~10K stores and our millions of customers is tremendous.”


Gui Serrano was a previous intern in the MBA program at CVS Health, working as a marketing and strategy intern in Store Brands. His hard work and his experience with his internship at CVS Health opened up several opportunities at the company. His internship led him to several promotions to his current title of Brand Manager. What enticed Gui to work in Store Brands and retail as a whole was the amount of growth available in the department as well as the fact that “Our decisions today impact sales tomorrow, and I am being literal. We can execute on our strategies and see how customers react on a daily basis.” The thing that truly excites Gui about the company is that “CVS is probably the only retailer in the drug channel that actually stands for something and makes purposeful decisions.”

CVS Health Summer Spanish Immersion Internship

CVS Health is proud to have hosted the inaugural 10-week Summer Spanish Immersion Internship program this summer.

The 20 selected Pharmacy Interns have basic to moderate Spanish fluency and are interested in relocating post-graduation to a Dominant Spanish market to help serve Hispanic patients.

The pharmacy interns that participated are enrolled in a college of pharmacy and worked across seven states. They had the opportunity to be immersed in CVS stores that have a Hispanic dominant patient population.  These bilingual students served our Hispanic population in unique ways.

The interns spent time diving deep into cultural competencies such as disease state prevalence in Hispanics, familiarity with OTC products used within the Hispanic population, and understanding cultural barriers to health care.  Our hope is to help increase Spanish fluency and create a larger workforce of Spanish speaking pharmacists to best serve the growing Hispanic population within the United States.

Spanish Immersion Intern Event
#TeamCVS attending UNIDAD of Miami Beach

One of our interns, Kevin Malloy, a 2nd-year pharmacy student from Virginia Commonwealth University recently attended a community health fair.  Kevin wrote of his experience:

“Last Friday I was fortunate enough to attend a community health fair at UNIDAD of Miami Beach. At the health fair, I was accompanying Navarro District Supervisor Chanel Valcarcel and Pharmacy Manager at #10709, Juan Rivera. We were joined by other representatives from various health care fields including dental, medical insurance, and social work professionals.

The population at the event was made up of female senior citizens, a majority of whom were Hispanic. I had the best time meeting and speaking will all of the people there. The majority of the women were there with questions; some just wanted to speak with Dr. Rivera, who knew many of them from his pharmacy up the street. Most of my time was spent talking to the community members while Dr. Rivera took their blood pressure. Some of the women had questions about their medications & immunizations, but they also shared some of their other health concerns such as insurance and finding new physicians.

The event was a great experience for an aspiring community pharmacist like myself. It was relevant to speak to people and focus on their individual questions and problems that they brought regarding their medication and health history. As an example, I had the opportunity to speak with one community member about her concerns with beginning the bisphosphonate therapy she has recently been prescribed.

The patient was very well-educated and health literate, and it was a unique experience for me to conduct a conversation with her that addressed her concerns to starting therapy. I learned a lot, got great first-hand experience working with senior citizens in a community setting, and I had a fun time.

Thank you to CVS Health, Navarro, Juan, and Chanel for allowing me to participate.”

We are excited for our interns’ experiences, like Kevin’s, and the impact they are making on a community. Sign up below for more information about how you can participate in our expanded program in 2018!

Eden Prairie, MN Hiring Event

Coram/CVS Health is hosting a career fair at our Center of Excellence!

Coram, a division of CVS Health, is a leading provider of specialty infusion and pharmacydistribution services with more than 85 locations, including over 65 ambulatory infusion suites.

Coram provides infusion therapies and services to over 20,000 patients each month, supporting care through all phases of their healthcare continuum.

POSITIONS AVAILABLE:

Insurance Verification Specialists | Medical Authorization Specialists

Ideal candidates will have excellent customer service and multi-tasking experience, working in a fast-paced and team-oriented environment. We are seeking motivated and energetic individuals who will offer amazing support to our customers while maintaining high-quality results. Healthcare experience is a plus but not required.

Avoid waiting in line – schedule an interview today!

To schedule an interview contact: Alexandra Mahfood, 727.277.4872 | alexandra.mahfood@cvshealth.com

You are officially invited!

Date: July 12, 2017

Time:  8:30am – 5:00pm

Where: 6455 Flying Cloud Dr. Suite 100 Eden Prairie, MN 55344

What to expect:

You’ll have the opportunity to meet with our recruiter which you might not be able to access any other way. To help you make the most of your time with us, we’ve pulled together a few tips for attending a CVS Health hiring event.

Before the event you should…

  1. Learn more about CVS Health.
  2. Review the jobs we have available in this location.
  3. Update your resume.
  4. Review the location and make sure you know your way to our office.

During the event you should…

  1. Dress professionally.
  2. Bring a few copies of your resume and a pen and paper for taking notes.
  3. Practice your introduction, including your name and career interests and state the type of position in which you are interested.
  4. Be prepared to ask specific questions like skills necessary, benefits, training and requirements.
  5. Remember to use good eye contact and a firm handshake.
  6. Ask for business cards from each person you meet and understand next steps.

We look forward to meeting you and discussing our available opportunities in Eden Prairie!

CVS Health Internship Update

By Chloe Skraly, 2017 CVS Health Recruitment Marketing Intern

As a new intern here at CVS Health, I have been given the opportunity to learn a lot as a new young professional in the workplace. The experience so far also made me glad to choose CVS Health as the company to intern for this summer. Everyone here is so friendly and willing to help, and my managers are always here to get me up on my feet when I may feel like I have fallen a little bit and need guidance.

What truly made CVS Health stand out to me with their internship program was the amazing speakers they brought in the first two days of orientation. Having past interns who were offered a full-time position and chose to stay with CVS Health opened up my eyes as a rising University senior to what CVS truly means to the people who work here every day. With only positive things to say about the internship program and the company as a whole, it excited me to be a part of such a great team of people who care so much about this company and our customers. I have learned that CVS Health truly puts their focus on the customer and what they want. The “alumni,” as you could call them, of the CVS Health intern program demonstrated the relevant projects they worked on and how they applied to the company. They felt that they had made a small difference in such a large company, which was great to hear.

The activity the interns did the first day of our orientation was really fun, and we all had a great time innovating and collaborating as undergrads (Masters and Undergrad students were separated for the activity). No one was negative or had a bad thing to say about the activity because we got to work together on ideas that we thought could help benefit CVS Health’s mobile application.

Being a student at Bryant University, I have participated in several activities like this, so I was excited to help out and work in a group as I do at school. What I think all of the interns, including myself, enjoyed a lot was the first night of orientation when we all went bowling together and had dinner. This made it easy to socialize with other young adults in a non-corporate setting to help us all get comfortable with each other and bond as a group.

By the third day of my internship, I was already attending vendor meetings with my team and got to learn a part of what my team does on a day-to-day basis. I have also been given projects that I know will help my team as a whole. I am glad I get to be a part of an organization that cares about my experience here at CVS Health and wants to help me learn about working in marketing and gain the real experience I need as a graduating student.

Learn more about internships at CVS Health jobs.cvshealth.com/internships.

 

30 Military Transition Tips

David_A_Lee

Written by David A. Lee, Director of Military Programs at CVS Health  and originally posted on the Thoughts Over Coffee blog.  

Going through transition myself as well as working with other transitioning service members I have had an opportunity to see what works and doesn’t work and heard and experienced the frustration associated with leaving the military and finding civilian employment. The following are a list of tips I have developed over the years and will continue to refine as I learn more.

  1. Plan Early, Plan Often.
    Everyone leaves service someday; the sooner you prepare for the transition the better off you will be. Take advantage of education benefits, build a network, and reach out to a company where you may want to work and ask them for the experience they recommend you have before you join them.
  2. Get resume and interviewing help.
    There are several non-profit organizations that can help with these. Your resume needs to help you stand out and highlight why a company should hire you. Your interview is an opportunity to sell yourself, something most of us are not good at and makes us uncomfortable.
  3. Network, Network, Network.
    People (veterans and non-veterans) who are referred to a company have a 20% chance of being hired. Applying to a job without a referral and your odds drop to 1.2%.
  4. Corporate Recruiters are not Career Counselors.
    Don’t expect a corporate recruiter to find a job for you. Do your own research and ask intelligent questions of a recruiter that helps you understand how your experience can best be used by a company.
  5. Find a Buddy.
    The transition process is frustrating and you need a buddy to help you stay positive. A negative attitude will come across in an interview and cost you a job. Your buddy can help you focus on the things that you can control.
  6. Develop an Elevator Pitch.
    You never know when and where you will encounter someone who can help you find a job. You need to be able to quickly communicate this to anyone, anywhere in a way that makes you standout from other candidates.
  7. Have Realistic Expectations.
    Just because you lead 100 people in the military does not mean that you will get a job leading 100 people in corporate America. Unless you have skills (beyond leadership) that are directly transferable to a company, then you should expect to take a step back to gain experience that they require.
  8. Get Business Cards.
    Part of your elevator pitch needs to include handing someone your business card. Keep it professional but make it easy for them to remember you later.
  9. Gather Intel.
    Do your research on companies where you may want to work. You need this information to decide if you want to work there and then to help get the job. Asking questions during an interview is important and you need this research to ask the right questions.
  10. Add to you Toolkit.
    There are programs that can help you get certified as a program manager, provide you certifications companies seek and fellowship opportunities. Get as many of these as you can so you stand out among other candidates for a job.
  11. Continue to Professionally Develop Yourself.
    Set aside time to read, take classes and attend events that develop you for a career outside the military. Do this even after you transition and are searching for job.
  12. LinkedIn is more than a digital resume.
    Share ideas through posts that may help someone gain insight into who you are. Join groups to network with others and to ask for help. Remember that everything you like or comment on may be seen by someone who can help you find a job, so stay positive!
  13. Ask the Right Questions.
    Most service members ask three questions regarding their next career:
     1. What will I do?
    2. Where will I do it?
    3. How much will I be paid?

    Most fail to ask…Is the culture of this company a good fit for me?
  14. Translate Your Skills.
    You need to help someone who never served understand how your experience is relevant to their company and job. HOWEVER, don’t go so far that another veteran has no idea what you did in the military. List your military title and the translation on your resume so veterans can help hiring managers understand why they should hire you.
  15. TAP is NOT Enough.
    TAP will begin to prepare you for the job search process but it will not prepare you for what happens beginning with your first day of employment.
  16. Don’t take the process personally.
    Don’t take the lack of feedback or rejection personally. Recruiters interact with thousands of people each year and can’t respond to everyone.You haven’t lost until you stop trying!
  17. Network, Network, Network.
    Yes, this was Tip #3 but it is worth repeating.Check out LinkedIn Group: Veteran Mentor Network
  18. Be professional.
    With less than 7% of the population having military experience you may be the first veteran someone has met.
  19. Stay Positive.
    Don’t use social media to complain about your transition. It’s not going to help you find a job. Save the complaints for when you are offline and talking to a buddy. You will stand out much better focusing on the positive.
  20. Learn the recruiting process.
    Companies have different processes for recruiting. Learn how they operate. On average it takes 30-60 days to fill a job once it is posted so don’t expect an answer back the day after you apply. Some companies collect all applicants before reviewing others begin right away.
  21. Find someone who has done the job.
    LinkedIn can be a great source for finding former employees who have worked at a company you are considering or who have even done the job. They may be able to give you insight that will help you get the job or avoid it.
  22. Take advantage of free help.
    TAP will not prepare you for everything you need. There are lots of non-profits out there that can provide assistance beyond what you get in TAP. In addition, there are apprenticeship programs and fellowship programs that can help with your transition.
  23. Focus only on what you can control.
    The only thing you can control in the interview is your behavior and your responses. Focus on listening carefully — taking notes if necessary — and on controlling your behavior and words.
  24. Present yourself as the solution.
    Answer questions in such a way that you are always keeping the hiring company’s requirements and goals in mind, not yours. Your answers should reflect how you fit in with this organizations aims and enhance their objectives.
  25. Prepare and Ask Questions.
    Questions demonstrate how well you prepared for an interview. Ask “what, how, and why” questions helps YOU to control the conversation. Get your interviewer to share information that helps you be more prepared for the next interview and eventually your job.
  26. Focus on what is important for the job.
    In the military it is not uncommon for leaders to ask about you personal life as well as professional but in a interview you should focus on what is important to do your job.
  27. Save Money for the Transition.
    Unlike civilians who can find a job and then give a two week notice, you need to give notice first which means you need to plan to support yourself after service and before employment. Know your expenses to determine when you may need a part time job.
  28. Learn about Healthcare.
    It is so easy when you are in uniform. The choices and costs are far more complex once you leave service. If you have a family member with special needs healthcare can be a deciding factor on where to live and work.
  29. Be Humble.
    The best leaders I knew in the military were humble. Your service doesn’t entitle you to anything. It’s your experience that companies want and humility is what they need.
  30. Find a Mentor.
    Veterati and American Corporate Partners are two places to start as you transition. Once you are hired find a mentor within the company.

Have other ideas?  Add them in the comments below.

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CVS Health is a values-based organization focused on helping people on their path to better health. Here, you’ll work alongside former members of the military and current reservists and members of the National Guard. Bring your unique skills to our industry, and we look forward to helping you grow your career.

We offer opportunities at all levels for U.S. Veterans and will enforce the Uniformed Service Employment and Reemployment Rights Act (USERRA).

Learn more about our Military hiring outreach at jobs.cvshealth.com/military 

 

Join us for our hiring event in Allentown, PA

We’re currently hiring in Allentown, PA and we’d like to meet you at our upcoming hiring event! We’re looking to fill positions in customer service and finance! We have a numerous open roles including:

See all our open roles and even apply before attending the event!

You are officially invited!

Date: April 20, 2017

Time:  Any time between 9am – 5pm

Where: CVS Health, 6990B Snowdrift Rd., Allentown, PA 18106

What to expect:

You’ll have the opportunity to meet with CVS Health recruiter that you might not be able to access any other way. To help you make the most of your time with us, we’ve pulled together a few tips for attending a CVS Health hiring event.

Before the event you should…

  1. Learn more about CVS Health.
  2. Review the jobs we have available in this location.
  3. Update your resume.
  4. Review the location and make sure you know your way to our office.

During the event you should…

  1. Dress professionally.
  2. Bring a few copies of your resume and a pen and paper for taking notes.
  3. Practice your introduction, including your name and career interests and state the type of position in which you are interested.
  4. Be prepared to ask specific questions like skills necessary, benefits, training and requirements.
  5. Remember to use good eye contact and a firm handshake.
  6. Ask for business cards from each person you meet and understand next steps.

We look forward to meeting you and discussing all our available opportunities in Allentown!

Listening to Members, Improving Products: Meet the CVS Health Team

CVS Health’s Pharmacy Benefits Management (PBM) team tackles complex business challenge with enviable veracity, their tenacity in problem solving only rivaled by their respect and care for patients, members and beneficiaries. CVS Health is growing its PBM Process and Product teams; are you ready to solve some of healthcare’s toughest challenges? Apply now at https://jobs.cvshealth.com/strategy

Get to know your future colleagues: