Strategic Health Plan Pharmacist Advisor

CVS Health Corporation; Town of Texas (WI); Hybrid; USD 111,000 - 250,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Wellness programs

Job summary

CVS Health Corporation seeks a Health Plan Clinical Advisor to manage the clinical relationship with health plans, influencing formulary and utilization management across Medicare, Medicaid, Exchange, and Commercial segments. You will analyze client data, drive profitability, and collaborate with internal teams to meet client goals while ensuring regulatory compliance.

This is a full-time, remote-friendly role in the United States with up to 50% travel.

Qualifications

• Active pharmacist license in good standing.
• Experience in a client-facing role within managed care.
• Understanding of utilization management trends and programs.

Responsibilities

• Manage clinical relationship with health plan leaders to influence formulary and UM decisions.
• Develop and execute business plans to improve profitability and growth while reducing waste.
• Collaborate with internal teams to implement clinical programs and formulary strategies.
• Provide consultative advice and pilot recommendations to clients.
• Travel up to 50% as needed.

Skills

Pharmacist license

Managed care

Client facing

Analytical ability

Travel up to 50%

Communication

Education

BS in Pharmacy or PharmD

Tools

PBM systems

Healthplan analytics

Job description

CVS Health Corporation seeks a Health Plan Clinical Advisor to manage the clinical relationship with health plans, influencing formulary and utilization management across Medicare, Medicaid, Exchange, and Commercial segments. You will analyze client data, drive profitability, and collaborate with internal teams to meet client goals while ensuring regulatory compliance.

This is a full-time, remote-friendly role in the United States with up to 50% travel.