RPh Operations Advisor - Med D

CVS Health; Austin (TX); Hybrid; USD 69,000 - 117,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking an RPh Operations Advisor to support Medicare Part D members and providers with pharmacy benefit requests. You will ensure accurate case setup, review clinical data for decisions, and contact providers for needed information while complying with Medicare guidelines.

The role requires a valid pharmacist license, PMD review experience in a Caremark PBM environment, strong multitasking skills, and the ability to work a rotating schedule including overtime and holidays.

Qualifications

• Active pharmacist license in good standing
• Clinical Pharmacist with Med D review experience in Caremark PBM environment
• Proficient with multiple software systems and a dual/extra monitor setup
• Typing speed of 30 WPM or greater
• Excellent oral and written communication skills
• Ability to multitask, prioritize, and manage time in a regulated environment
• Ability to review large volumes of information and apply clinical knowledge
• Ability to work independently and exercise critical thinking
• Flexible with rotating schedule incl. overtime, weekends and holidays

Responsibilities

• Support Medicare Part D members and providers with pharmacy benefits requests
• Ensure cases are set up accurately and documented per guidelines
• Review clinical information to support decision making
• Outreach to providers for additional information as needed
• Document all Medicare Part D requests in a timely, compliant manner

Skills

Pharmacist license

Med D review experience

Multi-software proficiency

Typing speed 30 WPM

Strong communication

Time management

Independent work

Critical thinking

Schedule flexibility

Education

BS in Pharmacy or PharmD

Tools

AS400

PeopleSafe

MHK

WI database

Microsoft Office

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

As an RPh Operations Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You will be responsible for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. This is a great opportunity to initiate a career with a leading healthcare company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience.

Required Qualifications

• Active pharmacist license in the state of residence that is in good standing
• Current experience as clinical Pharmacist reviewing Med D requests within Caremark PBM environment
• Demonstrated ability to utilize multiple software systems, simultaneously with a 2-screen workstation setup (Windows based operations, AS400, MHK, PeopleSafe, WI database, Microsoft office applications)
• Ability to type 30 WPM or greater
• Excellent oral and written communication skills
• Ability to multi-task, prioritize, and manage time effectively in a fast-paced, highly regulated environment
• Must be able to review large volume of information, determine importance, and apply clinical knowledge to assist in outcome
• Must be able to work independently and utilize critical thinking/problem solving skills to make case decisions
• Receptive to constructive feedback and flexible in adapting to change
• Flexibility with working a rotating schedule including overtime, weekends, and holidays.

Dedicated home workspace needed. Must be able to provide a quiet, uninterrupted work environment. Must have a workstation that is not accessible to common traffic and is secure from unintentional access. Must have stable personal high-speed internet and ability to hard-wire into company computer (cannot use wireless internet).

Preferred Qualifications

3+ years experience in Managed Care/PBM environment

Education

BS in Pharmacy or PharmD

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The Typical Pay Range For This Role Is

$50.48 - $84.62

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 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: 08/24/2026

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