Clinical Benefits Pharmacist

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary

Looking for a great opportunity to join a leading healthcare company? The Clinical Benefits Pharmacist (CBP) position is a chance to use your clinical and analytical skills as a member on our Clinical team. As a Clinical Benefits Pharmacist, your primary responsibilities will be:

- supporting clinical adjudication and drug information requests
- analyzing claim adjudication platform operational components for Utilization Management programs including Step Therapy, Prior Authorization, Quantity Limits, Drug Lists, Formulary and more.
- supporting new implementations activities as well as providing ongoing analysis and support for maintenance of business requests from the client
- operationalize client's requirements, perform various degrees of data analysis involving drug information and obtain queries when necessary to ensure that all clinical Utilization Management programs and Formulary setups are meeting client intent
- work closely with the client to ensure all requirements are understood and interpreted correctly
- partner with internal teams to build a seamless communication flow within CVS Health

This CBP position will have a focus on Medicare D.

This is a fully remote, 100% work from home role open to qualified candidates within the United States, with the ideal candidate residing in the Central, Mountain, or Pacific time zones.Required Qualifications

- 3+ years of experience as a pharmacist working in a PBM/managed care setting and/or a 1 year Managed Care Residency

- Must be a registered pharmacist in good standing

- Demonstrated experience with Formulary and Utilization Management Programs

- Intermediate proficiency with Excel

- Excellent verbal and written communication skills

- Demonstrated proficiency with RxCLAIM / AS400 system functionalityPreferred Qualifications
3+ years Med D experience

High level of expertise with Microsoft programs and applications

Education

BS in Pharmacy or PharmD required
Licensed pharmacist in good standing in state of residence Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$110,925.00 - $228,800.00This 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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 09/08/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Frankfort, KY

Job ID: CVS-R0695054_1008

Employment Type: OTHER

Posted: 2025-08-30T19:43:46