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Sr Clinical Pharmacist, UM Development

AT CVS Health
CVS Health

Sr Clinical Pharmacist, UM Development

Buffalo Grove, IL

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
The Sr Clinical Pharmacist, UM Development will be responsible for development and execution of clinical content for specialty programs and services across our Book of Business. The Sr Clinical Pharmacist, UM Development will be responsible for managing and executing long-term and ongoing departmental and enterprise initiatives. Knowledge of utilization management interventions including prior authorization, step therapy, quantity limits and formulary exception is required. Sr Clinical Pharmacist, UM Development will feel comfortable partnering in a matrix relationship with colleagues at all levels and teams. Additionally, Sr Clinical Pharmacist, UM Development will serve as a subject matter expert and key point of contact for direct and indirect teams. Sr Clinical Pharmacist, UM Development will have excellent communication skills and experience presenting to leadership.This role is responsible for supporting the immediate team, including connecting, training and helping other colleagues leveraging their knowledge as it relates to business rules and its applications. Responsibilities also include interfacing with leadership to support product development, enterprise formulary initiatives, and additional clinical activities based on the organizational and marketplace needs.This is a hybrid model role based out of our Buffalo Grove, IL or Pittsburgh, PA offices. Candidates will be required to work in-office 3 days per week, and can work out of either of those office locations.

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Required Qualifications

-Active pharmacist license that is in good standing

- 3+ years of managed care experience, inclusive of UM development experience and prior authorization experience

- Demonstrated understanding of utilization management interventions including prior authorization, step therapy, quantity limits and formulary exception is required.

- Proven proficiency in literature search and analysis of evidence-based medicine

- Excellent written and oral communication skills with a proven ability to distill complex concepts for leadership.

- Project and process management experience
- Ability to understand and optimize complex work-flow processes
- Comfort in working cross functionally while maintaining and improving inter-departmental relationships

- Strong clinical, written, and verbal skills with the ability to identify and translate clinical information into an actionable clinical program solution

- Skilled in various PC applications, including MS Office Products (Word, Excel, Access, PowerPoint

- Knowledge of PBM and benefit designPreferred Qualifications

- 3+ years specialty pharmacy experience, specifically in rare conditions (e.g., HAE, DMD, SMA)

- Leadership or project management experience

Education
BS in Pharmacy or PharmD required Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$123,250.00 - $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: 06/23/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Buffalo Grove, IL, USA
Job ID: CVS-R0613207_1001
Employment Type: Full Time

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • HSA
    • HSA With Employer Contribution
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Fertility Benefits
    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
  • Financial and Retirement

    • 401(K) With Company Matching
  • Professional Development

    • Tuition Reimbursement
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Diversity, Equity, and Inclusion Program