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CVS Health Clinical Pharmacist - UM Development, Custom Criteria in Pittsburgh, Pennsylvania

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 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: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, Irving, TX, Scottsdale, AZ or Hartford, CT office locations.

Required Qualifications BS in Pharmacy or PharmD

Active, unrestricted pharmacist licensure in state of residence

4+ years clinical pharmacist experience

2+ years managed care (PBM) pharmacist experience, and/or completion of a PGY1 Managed Care residency

Preferred QualificationsClinical Pharmacy Practice ResidencyEducation

Bachelor Degree, Pharmacy (required)Doctorate Degree, Pharmacy (PharmD) (preferred)

Pay Range

The typical pay range for this role is:

$87,035.00 - $206,206.00

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 jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 07/26/2024

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.