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.
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
Drug File and Adjudication
Pharmacy and Therapeutics Committee decision making process
Strong Clinical Skills
MS Office Suite including Access, Excel, Power Point and Visio
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
Pharmacy Practice or Managed Care residency preferred
Regulatory environment and applicable standards
Excellent oral and written communications skills
Excellent organizational skills
Resolve problems by influencing or motivating others
Bachelor's degree Pharmacy - required
Doctorate PharmD - preferred
Registered Pharmacist - required
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.
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits