The Clinical Benefit Pharmacist position is an opportunity to use your clinical and analytical skills as a member on our Clinical Anthem team. As an Anthem Clinical Benefit Pharmacist, your primary responsibilities will be:
- supporting clinical adjudication and drug information requests
- analyzing claim adjudication platform operational components for Utilization Management programs including Step Therapy, Prior Authorization, Quantity Limits, and more as well as Formulary
- supporting new implementations activities as well as providing ongoing analysis and support for maintenance of business requests from the client
- confirming requirements operationally, performing varying degrees of data analysis involving drug information and performing queries when necessary to ensure that all clinical Utilization Management programs and Formulary setups are being built as requested
- work closely with the client to ensure all requirements are understood and interpreted correctly
- work with internal departments to create a strong communication flow within CVS Health
- this CBP position will have a focus on Medicare D
1+ years of experience as a pharmacist working in a PBM/managed care setting or a 1 year Managed Care Residency
Must be a registered pharmacist in good standing
Demonstrated proficiency with RxCLAIM / AS400 system functionality
Knowledge of Formulary and Utilization Management Programs
Intermediate proficiency with Excel
Excellent verbal and written communication skills
- Experience in a client facing role or implementations role.
- Medicare Part D experience
Bachelor's degree in pharmacy or advanced degree (PharmD) required.
It’s a new day in health care.
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.
At CVS Health, we work every day to help people on their path to better health. Never has it been more important for us to deliver on our purpose to our valued customers, patients, members, and employees. With a presence in communities across the country, CVS Health colleagues are and will continue to be a critical piece of the country’s health care solution. The health and safety of our employees, patients, customers, and members is our top priority as we face the impact of COVID-19 together. If you would like to learn about the actions we are taking as a company as we learn more about COVID-19 and its spread, we encourage you to visit our COVID-19 resource center at https://cvshealth.com/covid-19
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran – we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. Please note that we only accept applications for employment via this site.
We provide reasonable accommodations to qualified individuals with disabilities. If you need to request an accommodation, a qualified interpreter, written information in other formats, translation or other services, please contact our Advice and Counsel Reasonable Accommodations team by emailing Advice and Counsel Reasonable Accommodations team or calling 877-805-9511.