Job Closed
This listing is no longer active.
CVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca
Pharmacist - Clinical Advisor
Location
United States
Posted
91 days ago
Salary
$110K - $249K / year
Seniority
Mid Level
No structured requirement data.
Job Description
Pharmacist - Clinical Advisor
CVS Health
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Health Plan Clinical Advisor is a client facing role that manages the clinical relationship by influencing multiple key decision makers at a health plan. These include the health plan’s pharmacy support team, pharmacists, medical directors, CMO as well as other senior health plan leaders. The Health Plan Clinical Advisor should be able to manage at least 2 and up to 4 market segments for any particular client (Medicare, Medicaid, Exchange, or Commercial). The Health Plan Clinical Advisor is responsible for proactively managing the clinical relationship alongside the business lead (SAE/SAD) to understand and drive each of their client’s priorities, financial targets, clinical goals and other commitments to their leadership. The Health Plan Clinical Advisor will analyze and evaluate the client’s data and competitive marketplace conditions and forces to develop and execute a comprehensive business plan that supports the client’s short- and long-term profitability and growth strategies. Key components being eliminating waste, reducing inefficiency and maximizing impact to manage chronic disease. This includes: - Collaborating with clients on analysis of their key marketplace competitors and those products and services. - Consulting with and recommending standard and custom formulary options and utilization management edits. - Collaborating with internal partners to develop or modify custom programs or formularies that meet the unique needs of health plan clients. - Collaborating with CVSH trade partners on formulary strategies to maximize rebate value and drives lowest net cost. - Consulting with and recommending utilization management programs or other clinical programs to a client. - Consulting with and recommending specialty drug strategy options. - Consulting with ANCS, to utilize clinical and financial reports to evaluate current benefit design and provide recommendations to clients on any opportunities. - Consulting and Influence clients on current drugs trends, drug pipeline, as well as proactive monitoring of FWA trends. - Consulting and influencing clients on a regular basis, developing a trusted consultative partnership that drives client loyalty and fulfills both clients commitments and CVSH goals. - Conducting Provider and Member outreach as needed for client communications. The Health Plan Clinical Advisor will consult with and advise the Clinical Benefits Pharmacist, and or other members of the Benefits and Operations teams so that those teams can timely and accurately implement a client’s requirements. The Health Plan Clinical Advisor will collaborate with CVSH internal partners to ensure compliance to any federal, state or local regulatory requirements that impact formulary, UM and or clinical programs and consult with any clients on the impact that such requirements might have on their plan. The Health Plan Clinical Advisor is accountable for ensuring that CVSH meets or exceeds any health plan client value targets each year and is responsible for proactively collaborating with business leads to identify client value and then provide consultative advice and follow up with the client on such recommendations. Consultative advice may include recommendations for program pilots, modification to existing CVSH programs to support the unique needs of the health plan segment and marketplace and/or how CVSH as an enterprise can support health plans through our open source model. The Health Plan Clinical Advisor is responsible for ensuring they meet or exceed their personal and departmental client satisfaction scores target each year. This position can be based out of a CVS Health Corporate Hub or can work remotely/work from home within the United States. Clinical Advisors must have the ability to travel up to 50% of the time as required to meet business needs, with the ideal candidate residing near a major airport. Required Qualifications 3+ years of managed care Pharmacist experience and/or 1 year of Managed Care Residency program. - Active pharmacist license that is in good standing. - Demonstrated experience in a client-facing role within the managed care environment - Demonstrated understanding of and experience with utilization management trends and programs within the managed care environment - Highly organized, detail oriented, proficient analytical ability with effective listening & presentation skills are required. Preferred Qualifications - 3-5 years of experience supporting Pharmacy Benefit Management (PBM) clients or within a health plan. - Experience in all market segments (Medicare, Medicaid, Exchange and Commercial) - Expertise in Utilization Management, Formulary Management and Clinical Products - Proven leadership skills. - Strong business acumen. - Commitment to client service and relationship building. - Experience implementing template and/or customized clinical programs. - Knowledge of PBM adjudication engine and other systems leveraged in support of clients. - AMCP Fundamentals of Managed Care Pharmacy Certificate or similar professional advancement. Education Bachelor of Science Pharmacy or PharmD. Active, unrestricted pharmacist licensure required Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $110,925.00 - $249,600.00 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: 03/31/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Related Guides
Related Categories
Related Job Pages
More Medical Reviewer Jobs
Urology Clinic Nurse
CommonSpirit HealthCommonSpirit Health is a nonprofit organization that is on a mission to improve people’s health while making “the healing presence of God known.” The orga
Role Description Are you a Registered Nurse (RN) with a passion for helping people and a knack for efficiency? Do you thrive in a fast-paced environment where you can make a tangible difference in patients' lives, all while being a vital part of a supportive team? Then get ready to inject some fun into your professional life as our new Urology Clinic Nurse (RN). We believe in providing top-tier, compassionate urological care, but we also believe that a little laughter and a positive attitude go a long way – for our patients and for us. If you're looking for a role where you can utilize your full clinical skillset while genuinely connecting with patients and enjoying your workday, then keep reading! - You'll be the friendly face and reassuring voice for our diverse patient population. - From explaining complex diagnoses in simple terms to providing pre- and post-procedure education, your ability to actively listen and empathetically communicate will shine. - You'll expertly assess patient needs, prioritize urgent calls, and skillfully guide patients through their care journey, ensuring they receive the right attention at the right time. - You'll maintain meticulous and accurate electronic health records (EHRs), ensuring all patient data is up-to-date and compliant. - You'll work seamlessly with our physicians, MAs, front desk staff, and other healthcare professionals to ensure a smooth and efficient patient flow. Qualifications - Current Registered Nurse (RN) license that allows you to practice in our state. - Graduate of an accredited nursing program. - Basic Life Support (BLS) from the American Heart Association required. Requirements - Up to $5000 Sign on Bonus Offered, paid out in FULL after 30 days of employment! - Location: CUMC-Bergan Urology Clinic -- 77th & Mercy. - Schedule: Monday-Friday 8a-5p, NO weekends, NO holidays & NO call! Benefits - If you are an LPN or have completed your medical assistant degree and are interested in joining our amazing urology team - please apply! (Pay will differ per position, apply to chat with a recruiter!)
Nursing Clinician State Reviewer
TX-HHSC-DSHS-DFPSJoin the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey.
Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage. Functional Title: Nursing Clinician State Reviewer Job Title: Nurse III Agency: Health & Human Services Comm Department: SSLC Operations Posting Number: 15049 Closing Date: 04/07/2026 Posting Audience: Internal and External Occupational Category: Healthcare Support Salary Range: $7,155.75 - $8,886.16 Pay Frequency: Monthly Salary Group: TEXAS-B-24 Shift: Day Additional Shift: Days (First) Telework: Eligible for Telework Travel: Up to 50% Regular/Temporary: Regular Full Time/Part Time: Full time FLSA Exempt/Non-Exempt: Exempt Facility Location: Job Location City: AUSTIN Job Location Address: 909 W 45TH ST #634 BLDG 4 Other Locations: MOS Codes: 290X,46AX,46FX,46NX,46PX,46SX,46YX,66B,66C,66E,66F,66G,66H,66N,66P,66R,66S,66T,66W Brief Job Description: Nurse III - The Nursing Clinician/State Reviewer (Nurse III) performs duties within the scope of practice attributed to the skills of a registered nurse and reports to the Nursing Services Discipline Coordinator at state office. Work involves planning, developing, coordinating, and evaluating quality assurance/quality improvement initiatives related to nursing and clinical care and in alignment with the Settlement Agreement. The position will gather data through various health monitoring tools which will identify clinical issues. The position evaluates nursing services and other levels of care through the analysis of statistical studies and performance evaluation reports and will provide recommendations for improvement to the Nursing Services Discipline Coordinator. This position will assist with the provision of education to nursing staff and others as it relates to identified deficiencies. Provides assistance and monitoring of goals and long-range plans for SSLC nursing departments. This position will serve in a dual capacity as a state office Nursing Consultant and as a State Reviewer (SR) for the Department of Justice Settlement Agreement (United States v State of Texas). The duties of the nursing consultant will include working closely with the State Supported Living Centers (SSLC) providing consultive and technical assistance to ensure that the structure, staffing, and operations of all nursing services provided at SSLCs conform with all relevant federal and state laws, rules and regulations. The Nursing Consultant works in coordination with SSLC directors, Chief Nurse Executives and Nursing Operation Officers to optimize nurse services. The duties as the SR will entail the review of pre-on site and on-site documents, conduct on-site observations and interviews (both facility staff and individuals), and will calculate scoring sheets and prepare narrative monitoring report comments. The position may be required to work overtime and/or extended hours and may serve in an on-call rotation. The position may travel up to 50% of the time to complete SR duties and other duties as assigned by the Nursing Services Discipline Coordinator. The position will, as assigned, serve on or facilitate work groups related to quality improvement of Nursing and Medical Services. Clear and concise verbal and written communication skills in addition to computer skills are essential along with the ability to work collaboratively with other medical staff and executive leadership. Demonstrated knowledge and experience in the use of an Electronic Health Records is preferred Essential Job Functions: Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned. Provides on-site mentoring and consultation to SSLCs regarding nurse training, deployment and retention efforts. Analyzes nursing recruitment and retention data, prepares reports, and works closely with the SSLC to adopt recommended improvement strategies for retention of nursing staff, and assists in developing a recruitment and retention plan for nursing staff. Reviews and analyzes nursing staff deployment, scheduling and overtime on an annual basis to the SSLCs providing recommendations for improvement to state office and the SSLCs. Utilizes assigned monitoring and audit tools, data is obtained and analyzed in order to provide an accurate clinical picture of nursing services provided to individuals served. Upon analysis of data, it provides recommendations for improvement and has the ability to communicate, teach, follow up, assist in implementation and follow up of quality improvement initiatives. Provides education to employees at all levels of the organization, individuals who reside at the facility, and external monitoring groups. Actively participate in and/or facilitate workgroups and committees as assigned. Practices professional & prudent nursing in compliance with the Nurse Practice Act and agency/facility policies & procedures. Prepares and provides reports and data analysis utilizing computer software programs. Reviews pre-onsite and on-site documents for designated areas of monitoring. Evaluate programs, procedures, or processes for effectiveness through a Quality Service Review tool. Participate in cross-team review discussions with the Settlement Agreement Monitoring Team as well as other State Reviewers to discuss agreements, disagreements, and methodology. Calculate scores and prepare a narrative within assigned timeframes after the on-site review. Responds to comments and questions about scores and narratives. Provides assistance and monitoring of goals and long-range plans for SSLC nursing departments. Evaluates the educational needs of SSLC nurses. Performs related and additional work as assigned. Travels up to 50% of the time to complete State Reviewer duties and other assigned on-site visits. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location. Knowledge, Skills and Abilities (KSAs): - Demonstrate knowledge of nursing techniques and procedures; of health care laws and regulations; of medical diagnoses and procedures; of accepted medical treatment patterns; of community health and nursing care principles, practices and procedures; of program regulations and procedures; and of utilization review and control measures. - Ability to provide patient care; to prepare and maintain records; to explain public health law; to organize, coordinate, and evaluate nursing activities and delivery of public health services; to interpret policies and procedures; to interpret health care regulations; to recognize patterns of medical necessity treatment; and to plan, assign, and/or supervise the work of others. - Ability to appropriately interact with individuals with developmental disabilities and staff members. - Knowledge of nursing care standards, and the Department of Justice Settlement Agreement. - Ability to interpret regulations and communicate them effectively both orally and in writing. - Knowledge of state and federal laws and ICF-IID (Intermediate Care Facility for Individuals with Intellectual/Developmental Disabilities rules, regulations, policy and procedures related to State Supported Living Centers preferred. - Excellent verbal and written communication skills. - Knowledge and application in computer/software. - Ability to work independently and productively with all levels of staff. - Ability to train all levels of staff. - Ability to make recommendations to the Nursing Services Coordinator and executive staff. - Knowledge and application of an Electronic Healthcare Records system preferred. Registrations, Licensure Requirements or Certifications: Licensed to practice as a registered nurse in the State of Texas or a state that recognizes reciprocity through the Nurse Licensure Compact. Initial Screening Criteria: - Nursing supervisory/administrative experience. - Three (3) years of nursing documentation experience. - Bachelor's Degree preferred. - Experience in leading teams - Involvement in nursing projects such as improving nursing education, auditing or other special projects designed to improve nursing practice, documentation, or clinical skills. Additional Information: Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aide, Medication Aide and Employee Misconduct and HHS List of Excluded Individuals/Entities (LEIE). Males between the ages of 18 – 25 must be registered with the Selective Service. All State Supported Living Center Employees are subject to Random Drug Testing. Flexibility in work hours may be required for this position. The position may be required to work overtime and/or extended hours. Must be willing to work weekends and holidays. The position is based in Austin. All applicants must be at least 18 years of age to be considered for employment at a state-operated facility. Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC. Active Duty, Military, Reservists, Guardsmen, and Veterans: Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions. ADA Accommodations: In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview. Pre-Employment Checks and Work Eligibility: Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks. HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form Telework Disclaimer: This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.
Role Description Medcor is looking to hire full-time Registered Nurses for our remote 24/7 Occupational Health triage call center! - The hours for this position include 8 to 10 hour shifts between 7:00am to 7:00pm CST. - Shifts could include 7:00am-5:00pm or 11:00am-07:00pm. - The start date for this triage class will be 04/27/2026. By joining our nursing team, you will be helping thousands of employers better manage their workplace injuries and improve the quality of healthcare for their employees. - Nurses must be able to talk on the phone for long periods while typing and navigating through various software applications simultaneously. - Nurses must visualize an injury while on the phone and clarify details about the injury while following our proprietary algorithms to guide the triage of the injured worker. Training - Training for this role will last 5-6 weeks, with 2.5 weeks of classroom instruction and 2.5 weeks of precepting. - Training schedule is Monday through Friday, from 8a-4p CST. - The training schedule is non-negotiable, and all training must be successfully completed within a 6-week time frame. - Following training, you will transition to your permanent schedule between the hours of 7a and 7p CST with an every-other-weekend requirement and holiday rotation. - Changes to the permanent schedule are not allowed within the first 12 months of employment. Typical Day in the Life of a Medcor Triage RN - Manage a rapid flow of incoming telephone calls from Medcor customers in a call center environment. - Document each call efficiently and accurately. - Monitor and track individual as well as call center goals, productivity metrics, and statistics. - Reflect all shift activities using the phone system and be responsible for personal schedule adherence. - Provide superior customer service to Medcor’s clients and employees. - Complete accurate assessment of symptoms and/or concerns utilizing Medcor’s Triage Algorithms. - Follow HIPAA Compliance Policies. Requirements - Have a valid RN license and current BLS (CPR) certification. - Be able to handle a high volume of consecutive calls. - Have strong technological skills as well as a typing speed of at least 30 WPM. - Work a major U.S. holiday rotation. - Work every other weekend. - Have effective written, verbal, and interpersonal communication skills. - Ability to read, analyze, and interpret triage tools and information along with care instructions to injured employees and their managers. - Be able to talk and/or hear; required to sit and use hands. - Specific vision abilities required include close vision for computers and written work with the ability to adjust focus. - Be able to work on a computer for long periods. - Have a private space in your home with 4 walls and a door for patient privacy. - Have access to high-speed internet (no satellite) within your primary residence. - Be able to receive and apply feedback. It's a Plus If - You have call center experience. - You have occupational health experience. Benefits - Paid time off. - Health and dental insurance. - 401K with match. - Education reimbursement. - More benefits available. Company Description - Stability! We’ve been around since 1984. - Potential for retention and performance incentives. - Opportunities galore! Medcor has a lot more to offer than just this job. - Training! We believe in it and we’ll train and support you to be the best you can be. - We have an open-door policy. Do you have something to say? Speak your mind!
Dental Hygienist - Claremont Dental Clinic
dentalcorpWe forge the path forward for dental professionals in Canada.
Evaluate and implement patient care, perform preventive dental hygiene services, educate on oral health, and build strong patient relationships while ensuring an optimal and consistent patient experience during visits.


