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A leading health solutions company is seeking a Health Plan Clinical Advisor to manage clinical relationships and provide consultative advice to key decision-makers at health plans. This role requires 3+ years of managed care experience and an active pharmacist license. The position involves significant analysis, strategic planning, and collaboration with clients and internal partners.
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.
The Health Plan Clinical Advisor is a client facing role that manages the clinical relationship by influencing multiple key decision makers at a health plan. These include the health plan\'s pharmacy support team, pharmacists, medical directors, CMO as well as other senior health plan leaders.
The Health Plan Clinical Advisor should be able to manage at least 2 and up to 4 market segments for any particular client (Medicare, Medicaid, Exchange, or Commercial).
The Health Plan Clinical Advisor is responsible for proactively managing the clinical relationship alongside the business lead (SAE/SAD) to understand and drive each of their client\'s priorities, financial targets, clinical goals and other commitments to their leadership.
The Health Plan Clinical Advisor will analyze and evaluate the client\'s data and competitive marketplace conditions and forces to develop and execute a comprehensive business plan that supports the client\'s short- and long-term profitability and growth strategies. Key components being eliminating waste, reducing inefficiency and maximizing impact to manage chronic disease. This includes:
The Health Plan Clinical Advisor will consult with and advise the Clinical Benefits Pharmacist, and or other members of the Benefits and Operations teams so that those teams can timely and accurately implement a client\'s requirements.
The Health Plan Clinical Advisor will collaborate with CVSH internal partners to ensure compliance to any federal, state or local regulatory requirements that impact formulary, UM and or clinical programs and consult with any clients on the impact that such requirements might have on their plan.
The Health Plan Clinical Advisor is accountable for ensuring that CVSH meets or exceeds any health plan client value targets each year and is responsible for proactively collaborating with business leads to identify client value and then provide consultative advice and follow up with the client on such recommendations. Consultative advice may include recommendations for program pilots, modification to existing CVSH programs to support the unique needs of the health plan segment and marketplace and/or how CVSH as an enterprise can support health plans through our open source model.
The Health Plan Clinical Advisor is responsible for ensuring they meet or exceed their personal and departmental client satisfaction scores target each year.
This position can be based out of a CVS Health Corporate Hub or can work remotely/work from home within the United States. Clinical Advisors must have the ability to travel up to 50% of the time as required to meet business needs.
Bachelor of Science Pharmacy or PharmD.
Active, unrestricted pharmacist licensure required
40
Full time
The typical pay range for this role is:
$110,925.00 - $249,600.00
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.
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 people
We 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:
For more information, visit the CVS Health benefits page or contact CVS Health Careers for details.
We anticipate the application window for this opening will close on: 10/17/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
* The salary benchmark is based on the target salaries of market leaders in their relevant sectors. It is intended to serve as a guide to help Premium Members assess open positions and to help in salary negotiations. The salary benchmark is not provided directly by the company, which could be significantly higher or lower.