Sr Clinical Pharmacist, Formulary Administration - Med D

CVS Health



Cleveland, OH

Why you should apply for a job to CVS Health:

  • 62% say women are treated fairly and equally to men
  • 52% say the CEO supports gender diversity
  • Ratings are based on anonymous reviews by Fairygodboss members.


    Position summary

    ies, drug lists, utilization management, and other clinical programs and related processes, assuring clinical appropriateness, accuracy, clinical consistency, and full compliance with applicable rules and regulations. Responsibilities also include preparation of CMS formulary files and member formulary drug lists, providing direction to the internal partners to implement downstream clinical activities, and supporting other formulary and utilization management related processes and requests. The Sr. Clinical Pharmacist leads within the Medical Affairs team supporting Medicare formularies and external cross-functional teams to build consensus in Medicare formulary and utilization management decision-making process and continual enhancement of the clinical management systems for the enterprise. The role will lead clinical workstream activities within Medical Affairs and key stakeholders across the organization to support customer needs.

    The Sr. Clinical Pharmacist role is responsible for leading across the Medical Affairs team and the broader organization, including connecting and directing other colleagues leveraging extensive knowledge as it relates to business rules and its applications. Responsibilities also include interfacing with other leaders (typically Director/VP and below) to support product development, enterprise formulary initiatives, and additional clinical activities based on the organizational and marketplace needs.

    The Sr. Clinical Pharmacist role typically manages larger projects and processes and has the ability to evaluate work from an end-to-end perspective. The role provides measurable input into current and newly developed clinical products, support services, clinical standards and/or operational implementation and execution. The role has a direct impact on the clinical goals and objectives and the overall impact on achievement of results from both a short-term and a long-term perspective. The role requires the ability to work independently and apply appropriate judgement and discretion in leading often highly complex projects and/or clinical deliverables. In-depth advanced knowledge and clinical skills are required with the ability to understand the business application and the external healthcare marketplace dynamics.

    This role requires a strong knowledge of PBM/managed care and Medicare formulary management including development and implementation and applicable CMS rules and regulations. The Sr. Clinical Pharmacist will need to think strategically, possess excellent clinical, communication, presentation, project management and time management skills to ensure all deliverables are aligned with broader strategies and project timelines. The role provides recommendations and influences strategic decision making.

    This is a hybrid role, and will be based out of our Buffalo Grove, IL, Solon, OH, Pittsburgh, PA, Scottsdale, AZ, or Cumberland, RI office locations.

    Required Qualifications

    • 7+ years experience in 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

    Demonstrated understanding of:

    • PBM and Managed Care

    • Formulary Management

    • Utilization Management

    • Drug File and Adjudication

    • Pharmacy and Therapeutics Committee decision making process

    Skill In:

    • Strong Clinical Skills

    • MS Office Suite including Access, Excel, Power Point and Visio

    Ability To:

    • Prioritize and handle multiple projects

    • Interpret concepts, data and general information into workable solutions and deliverables

    • Work independently based on strategic direction requiring limited direction to complete assignments

    • Plan and set objectives to deliver results that have a direct impact on business results

    • Solve complex problems and resolve critical issues leveraging expertise and experience

    Preferred Qualifications

    Pharmacy Practice or Managed Care residency preferred

    Knowledge of:

    • Regulatory environment and applicable standards

    Skill in:

    • Excellent oral and written communications skills

    • Excellent organizational skills

    Ability To:

    • Resolve problems by influencing or motivating others

    • Think strategically


    Bachelor's degree Pharmacy - required
    Doctorate PharmD - preferred
    Registered Pharmacist - required

    Pay Range

    The typical pay range for this role is:

    $105,446.25 - $227,100.00

    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

    CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

    You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

    CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.

    Why you should apply for a job to CVS Health:

  • 62% say women are treated fairly and equally to men
  • 52% say the CEO supports gender diversity
  • Ratings are based on anonymous reviews by Fairygodboss members.