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Position Summary
The Clinical Pharmacist will join an established clinical account team dedicated to serving a large federal client with employer, and Medicare/EGWP prescription benefit offerings. The role will be responsible to support the clinical operational work overseen by the clinical account team. Responsibilities include but not limited to:
Working on the development, creation, maintenance, and management of the client-specific clinical benefits, formularies, and utilization management edits.
Supporting the clinical and benefit teams in all clinical benefit and formulary set-up/coding efforts required to meet client-specific needs and requirements.
Performing tasks associated with clinical benefit and formulary documentation and reporting needs across all lines of business offered by the client.
Ensuring all relevant activities are at highest level of clinical appropriateness, accuracy, clinical consistency, and in full compliance with client requirements and applicable rules and regulations.
This role requires established knowledge of PBM/managed care activities, especially formulary and clinical benefit management. Knowledge Medicare/EGWP regulatory and formulary management requirements is a plus. The clinical pharmacist will need to have superior attention to details, possess excellent clinical, analytical, communication, project management and time management skills to ensure all deliverables are aligned with internal, and client requirements, as well as project timelines.
This is a hybrid position based out of our Phoenix, AZ office location. Candidate must be willing and able to report to that location on a weekly basis, 2-3 days per week with the ability to work remotely on other days.
Required Qualifications
Active pharmacist license in good standing with no restrictions in State of Arizona.
Minimum 2 years working experience in prescription drug benefit management within PBM, insurer or health plan setting, preferably in clinical operations and/or formulary management.
Ability and willingness to work in a highly dynamic environment.
Ability to work on multiple projects, prioritize, and resolve complex problems while meeting contractual obligations and deadlines determined by the client and the clinical account team.
Effectively work independently on assigned tasks/projects without need for daily supervision.
Minimum of 2 years of experience in Microsoft Office suite including utilizing Excel, Word, PowerPoint, Access, and Outlook.
Willingness to learn and adopt PBM systems and programs related to clinical benefit and formulary set up and management.
Facilitate cross functional collaboration and work with other clinical and/or operation teams to meet client needs and requirements.
Strong clinical, analytical, and problem-solving skills.
Excellent presentation and oral/written communication skills.
Preferred Qualifications
Previous experience in clinical/formulary operations within a PBM environment.
Experience in using tools and programs supporting PBM clinical/formulary management. This may include, but not limited to, RxClaim, RxArchitect and RxNavigator.
Experience in performing advanced reporting and analytical tasks using Microsoft Excel and Access.
Working knowledge of Medicare Part D requirements in particular those pertaining to prescription drug, formulary, and utilization management.
Education
BS in Pharmacy or PharmD
Active, unrestricted pharmacist licensure in Arizona
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$118,000.00 - $187,500.00This 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.
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.
Skills Required
- Active, unrestricted pharmacist license in good standing in the State of Arizona
- Minimum 2 years working experience in prescription drug benefit management within a PBM, insurer, or health plan
- Minimum of 2 years experience using Microsoft Office suite (Excel, Word, PowerPoint, Access, Outlook)
- BS in Pharmacy or PharmD
- Ability and willingness to work in a highly dynamic environment
- Ability to manage multiple projects, prioritize, and resolve complex problems while meeting contractual deadlines
- Ability to work independently on assigned tasks/projects without daily supervision
- Willingness to learn and adopt PBM systems and programs related to clinical benefit and formulary set up and management
- Facilitate cross-functional collaboration with clinical and operations teams
- Strong clinical, analytical, and problem-solving skills
- Excellent presentation and oral/written communication skills
- Previous experience in clinical/formulary operations within a PBM environment
- Experience using PBM tools such as RxClaim, RxArchitect, and RxNavigator
- Experience performing advanced reporting and analytical tasks using Microsoft Excel and Access
- Working knowledge of Medicare Part D prescription drug, formulary, and utilization management requirements
What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
