Clinical Pharmacist, Formulary Administration

CVS Health•Schaumburg, IL

1d•Hybrid

About The Position

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. The Clinical Pharmacist will be responsible for supporting the creation and maintenance of CVS Caremark's standard commercial formularies assuring clinical appropriateness, accuracy and clinical consistency. Responsibilities include supporting clinical workgroups, enterprise formulary initiatives, and additional formulary related clinical activities to meet the organizational and marketplace needs. The role will consult as a subject matter expert facilitating formulary decision-making process and continual enhancement of the formulary management systems for the enterprise, and provide direction to the internal partners to implement downstream formulary activities including adjudication, web/portal, communications, and publications. This position will also assist with the coordination of formulary activities to meet organizational goals, client needs, performance standards, and Plan requirements while ensuring compliance with established Policies and Procedures, Best Practices and applicable regulations and standards. This position requires attention to detail and strict adherence to timelines. This role will can be based out of our corporate hub in Buffalo Grove, IL in a hybrid model or work remotely if residing elsewhere in the United States.

Requirements

PharmD or equivalent clinical pharmacy degree.
Active pharmacist license in good standing.
3–5 years PBM, managed care, or UM experience.
Demonstrated formulary experience
Strong analytical, project management, and communication skills.

Nice To Haves

Experience managing state-specific formularies.
Familiarity with MH/SUD treatment guidelines.
Experience with formulary systems, automation, and AI-enabled tools.

Responsibilities

Support the creation, maintenance, and integrity of CVS Caremark’s standard commercial formularies.
Serve as a clinical subject matter expert supporting enterprise formulary decision-making process.
Lead and participate in clinical workgroups and enterprise formulary initiatives.
Leverage AI tools, automation, and analytics to improve formulary management efficiency.
Ensure adherence to regulatory timelines and internal quality standards.
Build, maintain, and quality-check formularies and drug lists.
Perform formulary analysis and reporting.
Develop and submit state and federal formulary files.
Manage state-specific formulary requirements and mandated variations.
Provide guidance for adjudication and downstream implementation.
Ensure UM strategies align with clinical best practices, MHPAEA, and are consistently applied across medical/surgical and MH/SUD drugs.
Partner with Medical Affairs, Legal, Compliance, Product, Trade/Finance, and Operations teams.
Coordinate implementation of formulary and UM changes.
Present analyses and recommendations to leadership.