Pharmacist - Clinical Operations Advisor

About Us

We're building a world of health around every individual --- shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger -- helping to simplify health care one person, one family and one community at a time.

About the Role

The Clinical Operations Advisor is a client-facing role that collaborates with the HP Clinical Advisor to understand the client's clinical strategy and roadmap to create a clinical operations plan. This role works with the Benefit Relationship Manager and client to facilitate gathering formulary and utilization management requirements and designs the drug-level setup for projects on the operations plan while ensuring compliance to internal best practices and federal and state guidelines.

The Clinical Operations Advisor designs clinical setups using Caremark technology solutions and supports the coding teams in loading clinical data into the adjudication system. This role partners with account team members to document clinical design best practices, provide input to streamline processes, and identify opportunities to improve the efficiency and accuracy of clinical setups.

The Clinical Operational Advisor supports internal and client audits of clinical setups within adjudication systems, which includes verifying client-approved requirements and design.

This position can manage multiple health plan clients across multiple lines of business including Medicare, Medicaid, Exchange, and Commercial. The role can be located in a CVSH Corporate Hub or has the ability to work remotely/work from home within the United States. Travel up to 5% of the time is required.

Required Qualifications

• Pharmacist -- Active Registered Pharmacist license in at least one state.
• 3+ years of prior relevant work experience as a pharmacist in a managed care (PBM) environment and/or completion of a PGY1 managed care residency.
• Demonstrated understanding of CVSH clinical portfolio, marketplace segments dynamics (Medicare, Medicaid, Exchange, and/or Commercial), and industry trends.
• Proficiency with Microsoft applications: Excel, PowerPoint, Word, Outlook, Access, Teams.
• Demonstrated experience with CVSH internal reporting and analytic tools for client management or PBM industry equivalent.
• Excellent written and verbal communication skills, both virtually and in person.
• Ability to analyze large volumes of clinical data and organize this data for downstream teams such as configuration and testing teams.
• Attention to detail to ensure data fidelity and data integrity, including understanding business rules for data transformation.
• Ability to work on multiple projects, prioritize, and resolve complex problems.
• Effectively work independently without daily supervision.
• Impact and influence others.
• Drive results and deliver on goals and commitments.
• Facilitate cross-functional communication and collaboration.
• Consult and influence internal stakeholders and client contacts.

Preferred Qualifications

• Experience supporting Pharmacy Benefit Management (PBM) clients or within a health plan.
• Experience in all market segments (Medicare, Medicaid, Exchange, and Commercial).
• Expertise in Utilization Management, Formulary Management, and Clinical Products.
• Experience implementing template and/or customized clinical programs.
• Knowledge of PBM adjudication engines and other systems leveraged in support of clients.
• Proven leadership skills.
• Commitment to client service and relationship building.

Education

• BS in Pharmacy or PharmD

Work Schedule & Details

• Anticipated Weekly Hours: 40
• Time Type: Full time
• Pay Range: $110,925.00 - $228,800.00 annually. This range is a guideline; actual pay will be based on factors like experience, education, and location. This position is eligible for a CVS Health bonus, commission, or short-term incentive program.

Benefits

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 belongs.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. Benefits include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details are provided during the application process and on Benefits Moments.

Application Window

• The anticipated application window for this opening will close on: 05/01/2026

Equal Opportunity Employer

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws. CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran, committed to diversity in the workplace.