Clinical Pharmacist

2 days ago


Montgomery, Alabama, United States CVS Health Full time
Transforming Healthcare with CVS Health

At CVS Health, we're committed to delivering enhanced human-centric healthcare for a rapidly changing world. Our purpose guides our commitment to innovation and excellence in everything we do.

Job Summary

We're seeking a highly skilled Clinical Pharmacist to join our Commercial Appeals Team. As a key member of our team, you'll play a critical role in evaluating and reviewing appeals requests, working closely with Medical Affairs to render coverage determinations based on clinical criteria and plan design.

Key Responsibilities
  • Evaluate and review appeals requests, ensuring timely and efficient decision-making
  • Collaborate with Medical Affairs to render coverage determinations based on clinical criteria and plan design
  • Verify insurance coverage and eligibility, interpreting clinical guideline criteria and consulting with physicians and other healthcare providers
  • Utilize clinical knowledge and resources to make informed decisions, while complying with department protocols
  • Communicate decisions promptly and efficiently to healthcare providers, health plans/employers, patients, and other healthcare professionals
Requirements
  • 2+ years' experience working as a clinical pharmacist in a PBM setting
  • Current experience working with the Caremark Commercial Appeals team
  • Experience using clinical resources, such as Micromedex and Lexicomp
  • Ability to prioritize, quickly assess, and manage multiple tasks and adapt to changing situations
  • Excellent organizational skills, strong detail orientation, and excellent oral and written communication skills
What We Offer

We offer a competitive benefit package, including vacation, 10 paid holidays per year, health/dental/vision insurance, employee discounted stock purchase program, 401K, tuition reimbursement, and 20-30% employee discount at all CVS stores. This is a remote role open to candidates within the United States.

Why Join CVS Health?

At CVS Health, we're committed to making a positive impact on the lives of our patients, customers, and colleagues. We offer a dynamic and supportive work environment, with opportunities for growth and development. Join our team and be part of something bigger than yourself.



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