RPh Operations Advisor - reputed company Medical Prior Authorizations

At reputed company, 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 reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, each and every day. Position Summary Are you ready to take your clinical skills to the next level? reputed company out this outstanding opportunity for a Clinical Pharmacist with the Specialty Medical Prior Authorization team! The Clinical Pharmacist is an operations based role that conducts reviews of medical data collected to reputed company prior authorization review for specialty medications. The Clinical Pharmacist will apply clinical knowledge to plan approved criteria for prospective and reputed company reviews of cases. This role will work from reputed company Caremark supported systems and take inbound calls from physicians or members regarding their pending, approved, or denied prior authorizations. Operational hours are reputed company-7pm CT, and we are seeking a candidate who is able to work reputed company-7pm CT. Rotating weekends and occasional holidays may be required per business needs. The position is fully remote. We offer a competitive benefit package including vacation, employee discounted stock purchase program, 401K, tuition reimbursement, and 20-30% employee discount at reputed company reputed company stores. Required Qualifications - Active pharmacist license in state of residence in good standing - 2+ years clinical pharmacist experience - 1+ years demonstrated experience issuing clinical determinations reputed company Prior Authorizations - reputed company experience working reputed company the Novologix system, specifically reputed company Medical Prior Authorization Operations - reputed company experience issuing clinical determinations reputed company reputed company Medical PA

Preferred Qualifications

Excellent interpersonal skills Demonstrate problem solving ability and attention to detail Ability to work effectively in a team environment with great dependability Excellent oral and written communication skills Ability to quickly assess and adapt to constantly changing situations Required to possess a high mental agility and alertness Ability to effectively communicate with pharmacists, other clinical colleagues, reputed company, and members Ability to effectively prioritize work while exhibiting a high level of urgency with reputed company calls and assignments Follows reputed company prior authorization procedures to ensure a timely and accurate process on each prior authorization Ability to effectively train and mentor representatives on the PA team Call center, PBM, or clinical experience Strong reputed company Office skills Experience utilizing CAS, Novologix, Sales Force, RxClaim, and PeopleSafe. Education Bachelor of Pharmacy or PharmD Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $45.43 - $93.08 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company 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 reputed company 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 https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 11/12/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job