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 Analyst Client Funded role on the CVS Clinical Account Services team is a great opportunity for an individual with research and analytical interest to use their skills in a managed care pharmacy environment. The individual will collect, analyze, and present clinical data. The individual will perform research and evaluate healthcare information from different sources to identify trends and business insights. The individual will utilize data tools to help the Clinical Advisors (Pharmacists) respond to data requests and support strategic clinical consultation to our client(s). The Clinical Analyst will work with Clinical Advisors on data requests primarily to support our Health Plan Clinical Advisors. This will include analyzing client data requests, regulatory requests, benefit documents, utilization management edits (prior authorization, quantity limits, step therapy, etc.), operational data, clinical programs and Utilization Management Microsite management. The Clinical Analyst will conduct research and translate this information into the appropriate data request format, consult with account teams and client contacts to fully understand client request, and work with internal partners to ensure the pharmacy benefit data is accurately represented per the request specifications.Responsibilities:• Support the client's Utilization Management Microsite, working with IT to ensure the site is maintained per client requirement
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• Supports clinical advisors to help meet client reporting requirements, including: utilization, disruption, maintenance of business, formulary coverage, drug spend, and fraud, waste, and abuse.
• Supports clinical advisors on data needed to support regulatory requests
• Supports internal partners to maintain formulary documentation
• Clarifies needs and suggests innovative ideas to meet client/clinical advisor requests
• Provides consultative analysis of results and suggests additional analysis, if appropriate
• Supports internal partners to confirm reporting and analyses are accurate and meet client intent
• Supports special projects and work groups as needed to improve efficiencies and client satisfaction
• Proactively suggests solutions and integrates best practices across multiple accounts and lines of business
• Suggests and creates innovative solutions for improving existing process flows
• Leverages pre-built and self-built tools to support Clinical Advisor data manipulation and interpretation needs
• Design and develop customized solutions to meet client needs, including driving accuracy, clarity, efficiency, and automation
• Work collaboratively with CVS Health clients during virtual meetings using a client-centered approach
• Provide guidance and best practices for available tools and existing processes
• Utilize proprietary systems, reporting tools and software (RxNavigator, RxArchitect, iTools, Tableau, Salesforce, Sharepoint, etc.) to generate necessary client reporting and conduct research
Assist in maintaining Utilization Management MicrositesRequired Qualifications
• 2 years of work experience in a health plan, PBM, Pharmacy, benefits, or insurance background
• 3 years of experience in Microsoft Office suite including proficient skills utilizing Outlook, Access, Word, Excel, and PowerPoint
Preferred Qualifications
• Not a licensed pharmacist position
• Pharmacy experience preferred
• Pharmacy Technician certification preferred
• Project Management Experience
• Strong Microsoft Office skills with an emphasis in Excel and/or Access
• 3+ years of experience in client/customer service-based environment
• Excellent communication and organization skills (able to track and handle issues, ensure the right teams are engaged, facilitate comprehensive and timely issue resolution, etc.)
• Excellent time management and multitasking skills (able to work independently and effectively manage workload)
• Strong attention to detail
• Strong analytical, and presentation skills• Excellent knowledge of Prescription Benefit Management (PBM) industry preferredEducation
High School Diploma or GED required; Bachelor's degree
preferredPay Range
The typical pay range for this role is:$43,888.00 - $93,574.80This 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 Benefits | CVS HealthWe anticipate the application window for this opening will close on: 01/27/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.