Job Description

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 Member Data Transition (MDT) Clinical Pharmacist will play a crucial role in the Historical Prior Authorization Review (HPAR) team. This position involves working closely with Implementation Managers, Clinical Advisors, and MDT Analyst partners to review and analyze Prior Authorization (PA) files, ensuring the accurate and efficient implementation of new client PA records. + Analyze PA files using various tools and resources to develop strategic solutions for seamless integration into the CVS/Caremark claims adjudication platform. + Collaborate across multiple functional areas within a matrixed organization to ensure PA records align with client intent and are correctly entered for accurate claims adjudication. + Consult directly with clients on PA logic and PA override entry. + Present project updates to leadership and escalate risks and issues as necessary. **Required Qualifications** + Registered Pharmacist with an active license in good standing. + Demonstrated knowledge of CVS Caremark clinical programs, including benefit plan design, member claim history, formularies, and utilization management. + Familiarity with all lines of business (Commercial, Medicare, Medicaid, Health exchanges). + Demonstrates working knowledge of RxClaim related to data queries, prior authorization management, and adjudication. + Self-motivated with a strong, positive attitude. + Excellent communication and organizational skills, with the ability to articulate complex/technical concepts to non-technical users. **Preferred Qualifications** + Advanced proficiency in Microsoft Office Suite (Word, PowerPoint, Excel, Outlook). + Experience managing through a CRM system, ideally Salesforce and eProject plan. + Ability to run pre and post load validation testing in EZTest tool. **Education** + BS in Pharmacy or PharmD required + Must be a registered pharmacist in good standing with the state where the license is held. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $106,200.00 - $225,000.00 This 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 people** We 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 We anticipate the application window for this opening will close on: 08/07/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Job Tags

Hourly pay, Full time, Temporary work, Work at office, Local area, Flexible hours,

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