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
We are seeking an experienced and highly skilled Clinical Pharmacist to support accreditation, regulatory compliance , and quality management initiatives across our organization. This position will work collaboratively with clinical and non-clinical teams, as well as external and internal business partners to ensure adherence to accreditation , regulatory adherence and manage clinical quality improvement initiatives. This role will play a key part in developing , analyzing, and monitoring performance metrics while supporting audits, market conduct exams, accreditation reviews and delegation oversight .
The successful candidate will demonstrate advanced expertise in pharmacy operations, formulary management, quality improvement and delegation oversight , with strong leadership and problem-solving abilities.
Key Responsibilities
* Develop, maintain, and monitor accreditation and compliance documentation for audits
* Collaborate with internal stakeholders (clinical, non-clinical, and operational teams) and internal as well as external partners to ensure quality and regulatory adherence.
* Oversee functional areas including:
- Pharmacy Call Center and Claims
- Specialty and Mail-Order Pharmacies
- Polices and Procedures
- Quality Management and Accreditation
- Prior Authorization/Coverage Determination and Formulary Management
- Drug Recall and Plan Benefits
- Pharmacy Network and Rebate Processes
- Contracting and Market Conduct Exam
*Provide leadership in developing policies, procedures, and operational improvement to enhance pharmacy compliance and service delivery
*Deliver high-quality reports and analyses that inform decision-making at all organizational levels.
*Support delegation oversight and ensure alignment with state and federal regulations.
Required Qualifications
7+ years work experience in pharmacy operations, compliance, and/or quality management
Registered Pharmacist (RPh or Pharm D) in good standing with no restrictions required.
Proven Mastery of
- Problem solving and decision making skills.
- Collaboration and teamwork
- Growth mindset with the ability to coach and develop others
- Execution and delivery of strategic initiatives
- Evaluating cost/benefits impacts to determine best outcomes
- Adapting to diverse work environments with clinical and non clinical teams.
- Report writing and data analysis
- Digital literacy and technology application skills.
Overnight travel required up to 20%
Preferred Qualifications
- Experience in Quality Management and Accreditation processes
- Market Conduct Exam Experience
- Formulary Management Background
- Delegation Oversight Experience
Education
- Doctor of Pharmacy (Pharm D) or Bachelor of Science in Pharmacy (BS in Pharmacy)
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$106,200.00 - $206,250.00
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 https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 10/01/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
