Clinical Pharmacist - Prior Authorization

Phoenix, Arizona, United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Pharmaceuticals, HealthcareIndustries

Requirements

Candidates must possess at least one year of pharmacist experience in Pharmacy Benefit Management and one year of experience with Prior Authorizations. A PharmD or BS in Pharmacy is required, along with active and unrestricted pharmacist licensure in the State of Arizona and their state of residence. Preferred qualifications include three years in Pharmacy Benefit Management, two years in Clinical Prior Authorizations, and experience with RxClaim.

Responsibilities

The Clinical Pharmacist will review Prior Authorizations, verify indications, and analyze clinical documentation to support these reviews. Responsibilities include providing internal pharmacist support to the PA team and member services, performing foreign drug reviews, medical record reviews, case analysis, and offering clinical support for the development of drug policies and clinical projects.

Skills

Prior Authorization Review

Clinical Documentation Review

Medical Record Review

Case Analysis

Drug Policy Development

Communication Skills

Pharmacy Benefit Management

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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