Job description
In the role the pharmacist will be working with drug file data and using it to maintain CVS template standards for various clinical programs. Also providing data and analytical assistance to the client account teams. This is a detail oriented role and correct interpretation of criteria must accurately reflect intent in the adjudication system. The pharmacist will ensure accuracy, quality, and timeliness of all work. Responsibilities include, but are not limited to: the creation of instructions to implement the Utilization management rules into the adjudicating platform, document review, assistance with system validation and audit. This position may also require the pharmacist to interact with internal partners via conference calls or meetings when needed. Use of RxClaim, Rxclaim query, MS excel, SalesForce as well as several Microsoft Access based tools will also be necessary to understand and use.
Pay Range
The typical pay range for this role is:
Minimum: 82,000
Maximum: 176,800
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
MS Excel Proficient.
Experience with prescription adjudication system.
Experience with Utilization management.
COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Preferred Qualifications
Rxclaim Coding experience
RxClaim Query/EZ Query experience
Benefits Coding Experience
SaleForce.com experience
MS Access experience
Education
Licensed Pharmacist
Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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.
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