Clinical Development Pharmacist, Medicare at CVS Health

Pittsburgh, Pennsylvania, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, PharmaceuticalsIndustries

Requirements

Active pharmacist license that is in good standing in state of residence
3+ years of clinical pharmacy experience
2+ years of experience with Medicare Part D
2+ years experience of clinical therapeutics for specialty and/or oncology drugs
Proven proficiency in literature search and evidence-based medicine
Excellent written and oral communication skills
Ability to work independently
B.S. Pharmacy or PharmD

Responsibilities

Create and maintain clinical content for drugs covered under the pharmacy benefit, with significant focus on Medicare Part D
Use and develop strong knowledge of specialty pharmaceuticals, disease management, and therapeutics
Apply knowledge of utilization management interventions including prior authorization, step therapy, quantity limits, and formulary exception
Work in a matrix relationship with business partners and product teams to identify, develop, and monitor the impact of programs supporting drug coverage through the pharmacy benefit
Interpret drug information to support utilization management (UM)
Create clinical content for Medicare Part B, including standard and client-requested programs
Act as consultative resource to product owners, Trade, account management, and clients

Skills

Clinical Pharmacy

Medicare Part D

Utilization Management

Prior Authorization

Step Therapy

Quantity Limits

Formulary Exception

Specialty Pharmaceuticals

Oncology Drugs

Disease Management

Therapeutics

Drug Information Interpretation

Medicare Regulations

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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