RPh Operations Advisor - Aetna Medical Prior Authorizations

linical Pharmacist will apply clinical knowledge to plan approved criteria for prospective and concurrent reviews of cases. This role will work from CVS Caremark supported systems and take inbound calls from physicians or members regarding their pending, approved, or denied prior authorizations.Operational hours are 8am-7pm CT, and we are seeking a candidate who is able to work 9am-6pm CT. Rotating weekends and occasional holidays may be required per business needs. The position is fully remote.We offer a competitive benefit package including vacation, employee discounted stock purchase program, 401K, tuition reimbursement, and 20-30% employee discount at all CVS stores.Required Qualifications

• Active pharmacist license in state of residence in good standing

• 2+ years clinical pharmacist experience

• 1+ years demonstrated experience issuing clinical determinations within Prior Authorizations

• Current experience working within the Novologix system, specifically Aetna Medical Prior Authorization Operations

• Current experience issuing clinical determinations within Aetna Medical PAPreferred Qualifications
  Excellent interpersonal skills
  Demonstrate problem solving ability and attention to detail
  Ability to work effectively in a team environment with great dependability
  Excellent oral and written communication skills
  Ability to quickly assess and adapt to constantly changing situations
  Required to possess a high mental agility and alertness
  Ability to effectively communicate with pharmacists, other clinical colleagues, healthcare professionals, and members
  Ability to effectively prioritize work while exhibiting a high level of urgency with all calls and assignments
  Follows all prior authorization procedures to ensure a timely and accurate process on each prior authorization
  Ability to effectively train and mentor representatives on the PA team
  Call center, PBM, or clinical experience
  Strong Microsoft Office skills
  Experience utilizing CAS, Novologix, Sales Force, RxClaim, and PeopleSafe.

Education
Bachelor of Pharmacy or PharmDAnticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$45.43 - $93.08This 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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• 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.

For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 08/17/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.