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Clinical Pharmacist - UM Development, Custom Criteria

AT CVS Health
CVS Health

Clinical Pharmacist - UM Development, Custom Criteria

Buffalo Grove, IL

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary
The Utilization Management (UM) clinical development pharmacist will develop clinically and ethically based content for drug coverage programs in support of prior authorization, step therapy, quantity and formulary review programs for CVS Health. The UM pharmacist will participate in the interpretation, review and development of content supporting client specific and standard drug coverage programs across the following business segments: Commercial, Medicaid, and Health Care Exchange. This position will interact with several key areas including Clinical Operations, Clinical Account Management, Formulary Administration, and Clinical Affairs. The UM Clinical Development pharmacist may be called on to participate in cross-functional teams where knowledge of UM processes and philosophy is needed to help meet enterprise business needs.Responsibilities:

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1. Development and peer review of content supporting standard and client specific drug coverage programs across the following business segments: Commercial, Medicaid, and Health Care Exchange.
2. Provide assistance to Medical Affairs, Clinical Development leadership, and Clinical Advisors in strategic projects (participate in cross functional teams, committee representation, etc.) as the subject matter expert in UM development.
3. Assist in training new or existing UM pharmacists on program revisions, enhancements and clinical positioning. Precept and/or mentor students and residents as requested.T his is a hybrid role, based in-office 3 days/wk with the opportunity to work from home the remaining days. Candidate must reside in commutable distance to our Buffalo Grove, IL, Pittsburgh, PA, Woonsocket, RI, or Hartford, CT office locations.Required Qualifications
BS in Pharmacy or PharmD

Active, unrestricted pharmacist licensure

4+ years clinical pharmacist experience

2+ years managed care (PBM) pharmacist experience, and/or completion of a PGY1 Managed Care residencyPreferred Qualifications
Clinical Pharmacy Practice Residency

Education

Bachelor Degree, Pharmacy (required)
Doctorate Degree, Pharmacy (PharmD) (preferred) Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$118,000.00 - $206,250.00This 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: 04/07/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Buffalo Grove, IL, USA
Job ID: CVS-R0525414_1002
Employment Type: Full Time

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • HSA
    • HSA With Employer Contribution
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Fertility Benefits
    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
  • Financial and Retirement

    • 401(K) With Company Matching
  • Professional Development

    • Tuition Reimbursement
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Diversity, Equity, and Inclusion Program