Strategic Health Plan Clinical Pharmacist Advisor

CVS Health Corporation; Washington; Hybrid; USD 111,000 - 250,000; Full time

Job summary

CVS Health Corporation seeks a Health Plan Clinical Advisor to manage clinical relationships across Medicare, Medicaid, Exchange, and Commercial segments. The role collaborates with pharmacy support teams, medical directors, and senior leaders to influence formulary strategies and drive client outcomes.

The advisor analyzes client data, develops business plans to improve profitability, and partners with internal teams to implement clinical programs while maintaining strong client satisfaction

Qualifications

• 3+ years of managed care pharmacist experience or 1 year in a Managed Care Residency program.
• Active pharmacist license in good standing.
• Demonstrated client-facing experience in a managed care environment.
• Understanding of utilization management trends and programs.

Responsibilities

• Manage the clinical relationship with health plan clients and influence decision makers.
• Analyze client data and market conditions to develop a comprehensive business plan.
• Collaborate with internal partners to modify formularies and implement utilization management edits.
• Advise on specialty drug strategies and clinical program opportunities for clients.
• Conduct provider and member outreach to support client communications.

Skills

Managed care experience

Client-facing

Pharmacist licensure

Analytical thinking

Presentation skills

Education

BS in Pharmacy or PharmD

Active pharmacist licensure (1 state+)

Job description

CVS Health Corporation seeks a Health Plan Clinical Advisor to manage clinical relationships across Medicare, Medicaid, Exchange, and Commercial segments. The role collaborates with pharmacy support teams, medical directors, and senior leaders to influence formulary strategies and drive client outcomes.

The advisor analyzes client data, develops business plans to improve profitability, and partners with internal teams to implement clinical programs while maintaining strong client satisfaction