Strategic Health Plan Pharmacy Advisor

CVS Health Corporation; Virginia (MN); Hybrid; USD 111,000 - 250,000; Full time

Job summary

CVS Health Corporation is seeking a Health Plan Clinical Advisor to manage clinical relationships across Medicare, Medicaid, Exchange or Commercial segments, influencing key decision makers, pharmacy support teams and medical leaders.

You will analyze client data, develop business plans, collaborate with internal partners on formulary strategies, utilization management, and clinical programs, and travel up to 50%.

Qualifications

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

Responsibilities

• Manage the clinical relationship across multiple health plan segments with key stakeholders.
• Consult on formulary options, utilization management edits, and program design.
• Collaborate with internal partners to develop or modify clinical programs and formularies.
• Influence payer strategies to maximize value, rebates, and cost efficiency.
• Travel up to 50% to support clients and engagements.
• Ensure compliance with regulatory requirements affecting formulary and clinical programs.

Skills

Client-facing

Utilization management

Analytical skills

Project coordination

Education

BS in Pharmacy or PharmD

Active pharmacist license in at least 1 state

Job description

CVS Health Corporation is seeking a Health Plan Clinical Advisor to manage clinical relationships across Medicare, Medicaid, Exchange or Commercial segments, influencing key decision makers, pharmacy support teams and medical leaders.

You will analyze client data, develop business plans, collaborate with internal partners on formulary strategies, utilization management, and clinical programs, and travel up to 50%.