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Remote Clinical Pharmacist - Prior Authorization Opportunity

Remote · USA Full-time New today

Join the CVS Health team and make a meaningful difference in the lives of our patients! We are seeking a highly skilled and compassionate Clinical Pharmacist to join our Prior Authorization team in a remote capacity. As a Clinical Pharmacist with CVS Health, you will play a vital role in ensuring that our patients receive the best possible care, while working in a dynamic and supportive environment that values your contributions and rewards your hard work.

As a Clinical Pharmacist - Prior Authorization, you will be responsible for collaborating with our prior authorization team to process referrals, evaluating and reviewing prior authorization requests, and rendering coverage determinations based on clinical criteria and plan design. You will also establish and maintain communication with healthcare providers, patients, and other stakeholders to ensure seamless and efficient care coordination.

Your key responsibilities will include:

  • Collaborating with technicians and prior authorization team members to process referrals and answer clinical questions
  • Evaluating and reviewing prior authorization requests and rendering coverage determinations
  • Communicating with healthcare providers, patients, and other stakeholders to ensure efficient care coordination
  • Maintaining professional and technical knowledge of drug and disease states for Specialty and Non-Specialty Pharmacy programs
  • Performing other related projects and duties as assigned, including attending training sessions and development meetings

We offer a competitive benefits package, including:

  • Competitive salary range: $38.63 - $83.17 per hour
  • Comprehensive health, dental, and vision insurance
  • 401(k) retirement savings plan and Employee Stock Purchase Plan
  • Paid Time Off (PTO) and paid holidays
  • Opportunities for professional development and growth
  • 20-30% employee discount at all CVS stores

To be successful in this role, you will need:

  • 2 years of experience working as a pharmacist in a PBM setting
  • Current experience working with commercial Prior Authorizations in PBM
  • Excellent organizational and communication skills
  • Ability to prioritize, quickly assess, and manage multiple tasks
  • Active pharmacist license in good standing in the state of residence

Preferred qualifications include:

  • PGY1/PGY2 residency experience
  • Prior authorization, call center, and clinical experience
  • Exposure to clinical and analytical problem-solving

Education: Bachelor's of Science - Pharmacy or Pharm.D.

Join our team and start making a difference in the lives of our patients today! Apply now to become a part of our dynamic and supportive team.

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