Clinical Pharmacist - Medicare Formulary

at CVS Health in Buffalo Grove, Illinois, United States

Job Description

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand – with heart at its center – our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

The Clinical Pharmacist engages within the Medical Affairs team to support the development and management of Medicare formularies and utilization management (UM) programs and the formulary/UM management systems for the enterprise. The role will support clinical workstream activities in meeting new rules and regulations requirements and new requests from internal and external customers. The Clinical Pharmacist is responsible for supporting the creation and maintenance of the CVS Caremark’s standard and client-modified formularies, utilization management programs/policies and assuring clinical appropriateness, accuracy, and clinical consistency.

This role is responsible for supporting the immediate team, including connecting, training and helping other colleagues leveraging their knowledge as it relates to business rules and its applications. Responsibilities also include preparation of CMS formulary files and formulary drug lists, providing direction to internal partners to implement downstream clinical activities, supporting other formulary and utilization management related processes and requests, and interfacing with other teams and leadership to support product development, enterprise formulary initiatives, and additional clinical activities based on the organizational and marketplace needs.

This is a hybrid role, based in-office 3 days/week with the opportunity to work from home the remaining days. Candidate must reside in commutable distance to our Buffalo Grove, IL, Pittsburgh, PA, Solon, OH, Scottsdale, AZ, or Cumberland, RI office locations.

Required Qualifications

· Experience: 3+ years in Heath Care setting (PBM or managed care environment) and/or completion of managed care residency

· Active pharmacist license that is in good standing

· Demonstrated experience with formulary management and Medicare Part D

· Strong Clinical Skills

· Proficiency in MS Office Suite including Access, Excel, Power Point and Visio

Demonstrated Knowledge of:

· PBM and Managed Care

· Formulary Management

· Utilization Management

· Drug File and Adjudication

· Pharmacy and Therapeutics Committee decision making process

Ability To:

· Prioritize and handle multiple projects

· Recognize problems and/or issues and engage the team to bring to resolution

· Apply knowledge or previous experience to support team work deliverables

Preferred Qualifications

· Pharmacy Practice or Managed Care residency

· Deep experience with Medicare Part D

· Knowledge of regulatory environment and applicable standards

· Excellent oral and written communications skills

· Excellent organizational skills

· Ability to resolve problems by influencing or motivating others

· Demonstrated ability to think strategically

Education

· Bachelor’s degree Pharmacy – required

· Doctorate PharmD – preferred

· Registered Pharmacist – required

Pay Range

The typical pay range for this role is:

$87,035.00 – $206,206.00

This 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 07/31/2024

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.