Clinical Pharmacist, Clinical Account Operations

CVS Health•Mesa, AZ

6d•$118,000 - $187,500•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 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.

Requirements

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.
Strong clinical, analytical, and problem-solving skills.
Excellent presentation and oral/written communication skills.
BS in Pharmacy or PharmD
Active, unrestricted pharmacist licensure in Arizona

Nice To Haves

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.
Knowledge Medicare/EGWP regulatory and formulary management requirements is a plus.

Responsibilities

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.
Facilitate cross functional collaboration and work with other clinical and/or operation teams to meet client needs and requirements.