Clinical Pharmacist - UM Development, Custom Criteria

CVS Health • Pittsburgh, PA

11d • $118,000 - $206,250 • 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. Position Summary The Utilization Management (UM) Clinical Development Pharmacist will develop clinically and ethically based content for drug coverage programs in support of prior authorization, step therapy, quantity and formulary review programs for CVS Health. The UM pharmacist will participate in the interpretation, review and development of content supporting client specific and standard drug coverage programs across the following business segments: Commercial, Medicaid, and Health Care Exchange. This position will interact with several key areas including Clinical Operations, Clinical Account Management, Formulary Administration, and Clinical Affairs. The UM Clinical Development pharmacist may be called on to participate in cross-functional teams where knowledge of UM processes and philosophy is needed to help meet enterprise business needs. This is a hybrid role, based in-office 3 days/wk with the opportunity to work from home the remaining days. Candidate must reside in commutable distance to our Buffalo Grove, IL, Pittsburgh, PA, Woonsocket, RI, or Hartford, CT office locations.

Requirements

• BS in Pharmacy or PharmD
• Active, unrestricted pharmacist licensure
• 4+ years clinical pharmacist experience, to include UM experience
• 2+ years managed care (PBM) pharmacist experience, and/or completion of a PGY1 Managed Care residency

Nice To Haves

• Clinical Pharmacy Practice Residency
• Doctorate Degree, Pharmacy (PharmD)

Responsibilities

• Development and peer review of content supporting standard and client specific drug coverage programs across the following business segments: Commercial, Medicaid, and Health Care Exchange.
• Provide assistance to Medical Affairs, Clinical Development leadership, and Clinical Advisors in strategic projects (participate in cross functional teams, committee representation, etc.) as the subject matter expert in UM development.
• Assist in training new or existing UM pharmacists on program revisions, enhancements and clinical positioning. Precept and/or mentor students and residents as requested.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level