Location: Remote PositionPay Range: $20.78 - $36.53 Position Summary: The Clinical Pharmacy Technician is an advanced pharmacy technician role that supports network-wide formulary management, therapeutic substitution processes, and clinical pharmacy operational initiatives across the AON network. This role partners closely with Regional Clinical Pharmacists to identify, coordinate, and execute opportunities that improve formulary adherence, optimize medication utilization, and support clinic transitions. The clinical pharmacy technician plays a critical role in quality assurance processes, therapeutic substitution execution, and the application of formulary adherence tools to drive alignment with AON preferred products. This position is responsible for facilitating timely and accurate implementation of clinical initiatives, monitoring utilization trends, and supporting data-driven decision-making. Working under the supervision of Regional Clinical Pharmacists, this role contributes to Pharmacy & Therapeutics (P&T) initiatives, drug shortage mitigation strategies, and other Network-Level clinical pharmacy efforts, serving as a key operational partner in advancing safe, effective, and cost-conscious patient care. Key Performance Areas: KPA 1 – Clinical Support · Assist with transcription verification processes to ensure accuracy and completeness of medication orders. · Support execution of therapeutic substitutions under pharmacist supervision. · Collaborate with Regional Clinical Pharmacists to ensure timely processing of substitution opportunities. · Maintain documentation and tracking of interventions. KPA 2 – Formulary Adherence & Optimization · Utilize formulary adherence dashboards to identify opportunities for AON preferred products. · Support review of non-preferred drug utilization. · Monitor trends and escalate gaps to clinical pharmacists. · Contribute to adherence improvement initiatives. KPA 3 – P&T and Clinical Initiatives Support · Assist with P&T initiatives to drive AON preferences. · Support implementation of formulary changes including biosimilars. · Participate in projects related to DUEs and cost optimization. · Assist with data collection and reporting. KPA 4 – Drug Shortage & Product Management Support · Assist with product conversions during drug shortages. · Support transitions to alternative agents per guidance. · Help communicate shortage updates and changes. KPA 5 – Supply Chain Operations & Issue Resolution · Work closely with Regional Clinical Pharmacists. · Communicate effectively with internal teams. · Support cross-functional collaboration. · Perform other duties as assigned. Position Qualifications/Requirements 1. Education: College degree (AS, AA or Higher) in Business/Health Care Administration or other related field, preferred. In lieu of degree, 4+ years of experience is required or the equivalent combination of education and experience. 2. Certifications/Licenses: · Certified Pharmacy Technician (CPhT), required. · Advanced Certified Pharmacy Technician (CPhT-Adv), required within 6 months. 3. Previous Experience: · Minimum of 5 years of experience as a pharmacy technician, 3 of which must be in hematology / oncology. · Experience working in OncoEMR or other EMRs, Preferred. 4. Core Capabilities: · Analysis & Critical Thinking: Critical thinking skills including solid problem solving, analysis, decision-making, planning, time management and organizational skills. Must be detailed oriented with the ability to exercise independent judgment. · Interpersonal Effectiveness: Developed interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and diversity awareness. Ability to work effectively with sensitive and confidential material and sometimes emotionally charged matters. · Communication Skills: Good command of the English language. Second language is an asset but not required. Effective communication skills (oral, written, presentation), is an active listener, and effectively provides balanced feedback. · Customer Service & Organizational Awareness: Strong customer focus. Ability to build an engaging culture of quality, performance effectiveness and operational excellence through best practices, strong business and political acumen, collaboration and partnerships, as well as a positive employee, physician and community relations. · Self-Management: Effectively manages own time, conflicting priorities, self, stress, and professional development. Self-motivated and self-starter with ability work independently with limited supervision. Ability to work remotely effectively as required. · Must be able to work effectively in a fast-paced, multi-site environment with demonstrated ability to juggle competing priorities and demands from a variety of stakeholders and sites. · Leadership and Mentoring: Effectively lead and facilitate group discussions, coach, mentor, motivate, and engage others to align to a common goal. Ability to effectively lead projects from inception through implementation and assessment. · Human Resources Management: Effectively hire, coach and support staff develop, as applicable, as well as manage resources, performance and employee relations, and supervise within established policies, procedures and legislation. · Computer Skills: - Proficiency in MS Office Word, Excel, Power Point, and Outlook required. 5. Travel: <25% 6. Standard Core Workdays/Hours (specify weekends and call requirements): Monday to Friday 8:00 AM – 5:00 PM.

Where You’ll Work Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health – one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. Our 130+ clinics across the state of California deliver high-quality, patient-centric care with an emphasis on humankindness. Through affiliations with Dignity Health hospitals, along with our joint ventures and partnerships, we offer a robust, state-of-the-art health care delivery system in the communities we serve .We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service. One Community. One Mission. One California Job Summary and Responsibilities As our Utilization Review LVN Precert I, your focus will be to provide high quality, cost-effective care which will enable patients to achieve maximum medical improvement while receiving care deemed medically necessary. The LVN assists in determining appropriateness, quality and medical necessity of referral requests using pre-established guidelines. This position supports the Medical Group in effective management of the managed care patient. This position may be assigned cases in pre-authorization areas, in skilled nursing facility review or in concurrent review. To be successful in this role, you will effectively manage patient charts, demonstrating enthusiasm, efficiency, and empathy, while ensuring accurate application of criteria to support optimal patient care and operational flow. - Conducts pre-authorization referral reviews, following workflow as written, document criteria to make determination or recommendation and process the referral in a timely manner.- Manages assigned queues on a daily basis working oldest referrals first to assure 98% compliance with ICE timeframes.- Follows job work aide in sequence of performing job, including checking eligibility on health plan websites. Demonstrates 100% accuracy of identification of Medical Group member before referral review is initiated.- Determines correct type of referral and utilizes correct criteria in performing review and documents appropriate sections with 95% accuracy. Researches correct information and/or uses pend letter appropriately when facts are needed to reach determination.- Preps case thoroughly, concisely and clearly for physician review. Researches EMR, criteria, medical policy and past history of member to detail case cleanly for MD. Watches for follow up and processes denials as indicated, correct identification of reasons for denial.- Recommends and coordinates interventions to facilitate high quality, cost-effective care, monitoring treatment, progress and outcomes of patients. ***This position is work from home within California. Job Requirements Minimum Qualifications: - 0-3 years of LVN experience.- Graduation from an accredited Licensed Vocational Nursing program.- Clear and current CA Licensed Vocational Nurse (LVN) license.- Familiarity with healthcare regulations, including HIPAA, CMS, and state-specific requirements- Knowledge of UM operations.- Strong knowledge nursing requirements in a clinical setting.- Knowledge of utilization management programs as related to pre-set protocols and criteria.- Knowledge of health plans, medical specialty procedures and diagnoses.- Ability to work within an interdisciplinary structure and function independently in a fast paced environment while managing multiple priorities and meeting deadlines.- Ability to apply clinical judgment to complex medical situations and make quick decisions.- Ability to read and interpret benefit contract specifications.- Ability to understand and follow established criteria and protocols used in managed care functions.- Strong organization skills.- Effective telephone and computer data entry skills.- Ability to formulate ideas and solutions into appropriate questions and assess/interpret the verbal responses Preferred Qualifications: - Physician group experience preferred.- Experience at meeting deadlines by prioritizing workflow preferred.- - General knowledge of UM and Managed Care preferred.- Use of InterQual guidelines preferred.- Knowledge of California health plans and differences between commercial and advantage plans preferred.- Familiarity with business practices and protocols with ability to access data and information using automated systems preferred.- Ability to communicate effectively with coworkers, members, their families, physicians and health care providers preferred.

Where You’ll Work Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health – one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. Our 130+ clinics across the state of California deliver high-quality, patient-centric care with an emphasis on humankindness. Through affiliations with Dignity Health hospitals, along with our joint ventures and partnerships, we offer a robust, state-of-the-art health care delivery system in the communities we serve .We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service. One Community. One Mission. One California Job Summary and Responsibilities As our Utilization Review LVN, your focus will be to provide high quality, cost-effective care which will enable patients to achieve maximum medical improvement while receiving care deemed medically necessary. The LVN assists in determining appropriateness, quality and medical necessity of referral requests using pre-established guidelines. This position supports the Medical Group in effective management of the managed care patient. This position may be assigned cases in pre-authorization areas, in skilled nursing facility review or in concurrent review. To be successful in this role, you will effectively manage patient charts, demonstrating enthusiasm, efficiency, and empathy, while ensuring accurate application of criteria to support optimal patient care and operational flow. - Manages assigned queues on a daily basis working oldest referrals first to assure 98% compliance with ICE timeframes.- Follows job work aide in sequence of performing job, including checking eligibility on health plan websites. Demonstrates 100% accuracy of identification of Medical Group member before referral review is initiated.- Determines correct type of referral and utilizes correct criteria in performing review and documents appropriate sections with 95% accuracy.- Researches correct information and/or uses pend letter appropriately when facts are needed to reach determination.- Preps case thoroughly, concisely and clearly for physician review. Researches EMR, criteria, medical policy and past history of member to detail case cleanly for MD. Watches for follow up and processes denials as indicated, demonstrating correct identification of reasons for denial.- Recommends and coordinates interventions to facilitate high quality, cost-effective care, monitoring treatment, progress and outcomes of patients. ***This position is work from home within California. Job Requirements Minimum Qualifications: - 3 years Utilization Management (UM) experience.- 5 years LVN experience.- Clear and current CA Licensed Vocational Nurse (LVN) license.- Strong knowledge nursing requirements in a clinical setting.- Knowledge of utilization management programs as related to pre-set protocols and criteria.- Knowledge of health plans, medical specialty procedures and diagnoses.- Ability to work within an interdisciplinary structure and function independently in a fast paced environment while managing multiple priorities and meeting deadlines.- Ability to apply clinical judgment to complex medical situations and make quick decisions.- Ability to read and interpret benefit contract specifications.- Ability to understand and follow established criteria and protocols used in managed care functions.- Strong organization skills.- Effective telephone and computer data entry skills.- Ability to formulate ideas and solutions into appropriate questions and assess/interpret the verbal responses. Preferred Qualifications: - Experience at meeting deadlines byprioritizing work flow preferred.- Physician group experience preferred.- General knowledge of UM and Managed Care preferred.- Use of InterQual guidelines preferred.- Knowledge of California health plans and differences between commercial and advantage plans preferred.- Familiarity with business practices and protocols with ability to access data and information using automated systems preferred.- Ability to communicate effectively with coworkers, members, their families, physicians and health care providers preferred.

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. - This role requires the nurse to exercise clinical judgment and perform the following duties: - Review and interpret clinical documentation obtained from medical records or systems. - Apply clinical decision-making to utilize appropriate clinical criteria and policies for post-service claims - Coordinate clinical resolutions independently, with clinician/MD support as required - Act as a resource for customer service and claims processing teams - Train new staff and provide cross-training to existing team members - Identify trends and provide feedback to leadership if discrepancies or potential fraudulent activities are identified - Remain current with applicable laws, regulations, and internal workflows to ensure full compliance with organizational and state-specific requirements Required Qualifications: - A minimum of 2–3 years of professional experience as a licensed - Registered Nurse (RN) Licensure in the state they reside - Strong analytical skills to assess medical claims Preferred Qualifications: - Computer proficiency, Microsoft Suite - Utilization Management experience Education: - Bachelor’s in Science and Nursing Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $29.10 - $62.32 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 04/13/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.