Strategic Health Plan Pharmacist Advisor

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

Benefits offered by this job

Medical benefits

Dental & Vision

Retirement plans

Paid time off

Job summary

CVS Health Corporation seeks a Health Plan Clinical Advisor to manage clinical relationships with health plans, advising on formulary strategies and utilization management. You will work across Medicare, Medicaid, Exchange, and Commercial segments alongside SAE/SAD leaders to drive profitability and growth while reducing waste.

The role requires 3+ years in managed care pharmacy, an active pharmacist license, and strong analytical and communication skills.

Qualifications

• 3+ years of managed care pharmacist experience and/or 1 year of residency
• Active pharmacist license in good standing
• Demonstrated client-facing experience in managed care
• Understanding of utilization management trends in managed care
• Highly organized with strong analytical and presentation skills

Responsibilities

• Manage clinical relationship with health plan leaders and pharmacy support teams
• Develop and execute business plans to meet client goals and CVSH targets
• Collaborate to design formulary options and utilization management edits
• Advise on specialty drug strategies and clinical programs for clients
• Ensure compliance with federal/state/local regulations impacting formulary and UM

Skills

Pharmacist license

Managed care experience

Client-facing

Analytical skills

Presentation skills

Regulatory knowledge

Travel readiness

Education

BS in Pharmacy or PharmD

Tools

PBM systems

Job description

CVS Health Corporation seeks a Health Plan Clinical Advisor to manage clinical relationships with health plans, advising on formulary strategies and utilization management. You will work across Medicare, Medicaid, Exchange, and Commercial segments alongside SAE/SAD leaders to drive profitability and growth while reducing waste.

The role requires 3+ years in managed care pharmacy, an active pharmacist license, and strong analytical and communication skills.