Job Description:
• Support Medicare Part D members and providers with requests related to pharmacy benefits
• Accurately set up cases for members
• Review clinical information to make decisions on requests
• Perform outreach to providers for additional information when needed
• Ensure accurate decisions comply with compendia, Medicare guidance, and required timelines
• Review information and complete timely, accurate documentation of Medicare Part D requests
• Promote a best-in-class service experience
Requirements:
• Active pharmacist license in the state of residence that is in good standing
• Current experience as clinical Pharmacist reviewing Med D requests within Caremark PBM environment
• Ability to utilize multiple software systems simultaneously with a 2-screen workstation setup, including Windows based operations, AS400, MHK, PeopleSafe, WI database, and Microsoft Office applications
• Ability to type 30 WPM or greater
• Excellent oral and written communication skills
• Ability to multi-task, prioritize, and manage time effectively in a fast-paced, highly regulated environment
• Ability to review large volumes of information, determine importance, and apply clinical knowledge to assist in outcomes
• Ability to work independently and utilize critical thinking/problem-solving skills to make case decisions
• Receptiveness to constructive feedback and flexibility in adapting to change
• Flexibility to work a rotating schedule including overtime, weekends, and holidays
• Dedicated home workspace with a quiet, uninterrupted work environment
• Workstation must not be accessible to common traffic and must be secure from unintentional access
• Stable personal high-speed internet and ability to hard-wire into the company computer; wireless internet cannot be used
• Preferred: 3+ years of experience in a Managed Care/PBM environment
• BS in Pharmacy or PharmD
Benefits:
• CVS Health bonus, commission or short-term incentive program in addition to the base pay range
• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources supporting physical, emotional, and financial well-being