Clinical Pharmacist - Aetna Medicaid Prior Authorization (AZ or TX Licensed)

CVS Health Corporation; Louisiana (MO); Hybrid; USD 95,000 - 194,000; Full time

Job summary

CVS Health Corporation is seeking a Medicaid Prior Authorization Pharmacist to support Medicaid Prior Authorization for the clinical team. This fully remote role requires an active TX or AZ pharmacist license and to obtain the secondary license within 90 days of hire.

The position is 40 hours per week from a nationwide pool of candidates. Ideal candidates have 3+ years of pharmacist experience in managed care or prior authorization, with strong clinical decision-making using evidence-based

Qualifications

• Active TX and/or AZ pharmacist license
• Secondary TX/AZ license required within 90 days of hire
• Clinical decision-making using evidence-based guidelines and formularies
• Experience in a high production, remote team environment
• 3+ years as a pharmacist or PGY1 managed care residency with prior authorization
• Understanding of formulary designs and prescription benefit trends

Responsibilities

• Support Medicaid Prior Authorization processes and clinical decision-making.
• Review clinical information and determine eligibility per guidelines.
• Collaborate with remote teams to ensure efficient prior authorization workflows.

Skills

Clinical decision-making

Evidence-based guidelines

Formularies/PDLs

Remote team collaboration

Pharmacist experience

PGY1 managed care

Education

BS in Pharmacy or PharmD

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

Ready to take your clinical skills to the next level? Check out this outstanding opportunity for a Medicaid Prior Authorization Pharmacist with Aetna!

This is a Clinical Pharmacist position supporting Medicaid Prior Authorization.

An active TX or AZ pharmacist license that is in good standing is required. New hire is required to obtain the secondary license (AZ or TX) within 90 days of hire.

We are hiring for the 10:30 am - 7:00 pm CST shift (post training). The training schedule is: 10:00 am - 6:30 pm CST. You will be required to work one Saturday every 4-6 weeks and occasional holidays.

This is a fully remote position open to qualified candidates within the United States who currently hold active, unrestricted TX or AZ pharmacist licensure.

Required Qualifications

• Active and unrestricted TX and/or AZ pharmacist license
• New hire is required to obtain the secondary license (AZ or TX) within 90 days of hire.
• Demonstrated experience with clinical decision-making while applying evidence-based clinical guidelines/criteria; utilizing formularies/preferred drug lists.
• Experience working in a high production, remote team environment
• 3+ years experience working as a pharmacist or completion of PGY1 managed care residency, including prior authorization experience
• Demonstrated understanding of clinical program components, formulary designs, and prescription benefit trends

Preferred Qualifications

• Medicaid or Medicare experience
• Medicaid prior authorization experience
• Experience reviewing medical records, clinical literature, and composing SOAP notes

Education

BS in Pharmacy or PharmD

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $94,500.00 - $193,600.00

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.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 09/27/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.