Clinical Pharmacist
CVS Pharmacy - Pittsburgh, PA
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Job DescriptionThe Clinical Pharmacist is responsible for playing an integral part of the Medicare Quality and Audit teams. The Clinical Pharmacist must be familiar with the Centers for Medicare & Medicaid Services (CMS) communications (e.g., proposed & final rules, chapter guidance, memos, audit protocols, etc.) and able to assess impact to the Coverage Determination, Appeals, and Grievances teams (CDAG) and the Organizational Determination, Appeals, and Grievances (ODAG) teams. He/she must be able to create and maintain relationships with external partners such as, but not limited to, Pharmaceutical Care Management Association (PCMA) and internal partners such as, but not limited to, Regulatory Affairs, Client Audit, and Medical Affairs. The Clinical Pharmacist must work with internal partners and Regulatory Affairs to submit comments & questions to CMS (e.g., respond to CMS' request for comments, seek clarification on vague guidance) and assist as needed to implement new and revised regulatory requirements. He/she will also consult with various business partners to provide CDAG/ODAG regulatory subject matter expertise; help to shape compliant and effective department policies, communications, system set-up, etc. This induvial may also assist other support teams as needed (ex. create content for member-facing letters, help resolve FWA issues, investigate executive complaints, etc.). It is imperative this individual to have a strong background in Medicare guidance and working across diverse teams. The Clinical Pharmacist will work as part of the team to meet business unit objectives and will be responsible for applying their clinical expertise in their strategies, as well as completing data analysis and various clinical projects. The ideal candidate will have 3-5 years of demonstrated success in a Medicare-related field and/or PBM experience.Pay RangeThe typical pay range for this role is:Minimum: 82,000Maximum: 176,800Please 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 Qualifications1. Organize, prioritize and manage multiple tasks on a regular basis with high level of detail 2. Excellent Oral and Written communication skills and interpersonal skills3. Customer Service internally and externally4. Adaption to Change Management 5. Self-motivated with a strong attention to detail6. Ability to work in a high production, time sensitive environment7. Able to prioritize and manage multiple tasks8. Demonstrates resourcefulness in problem-solving 9. Displays confidence in the ability to learn complex material10. Computer Knowledge including Microsoft office products, Windows based operations, data entry and clinical systemsCOVID RequirementsCOVID-19 Vaccination RequirementCVS 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 QualificationsExperience in Medicare Parts B and D. Background in National Coverage Determinations (NCD's) and Local Coverage Determinations (LCD's).EducationBachelor's Degree required, Masters or Doctorate preferred, Licensed Pharmacist requiredBusiness OverviewBring 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. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Created: 2024-09-07