Clinical Pharmacist - UM Development, Custom Criteria

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 Utilization Management (UM) Clinical Development Pharmacist will develop clinically and ethically based content for drug coverage programs in support of prior authorization, step therapy, quantity and formulary review programs for CVS Health. The UM pharmacist will participate in the interpretation, review and development of content supporting client specific and standard drug coverage programs across the following business segments: Commercial, Medicaid, and Health Care Exchange. This position will interact with several key areas including Clinical Operations, Clinical Account Management, Formulary Administration, and Clinical Affairs. The UM Clinical Development pharmacist may be called on to participate in cross-functional teams where knowledge of UM processes and philosophy is needed to help meet enterprise business needs. Responsibilities: 1. Development and peer review of content supporting standard and client specific drug coverage programs across the following business segments: Commercial, Medicaid, and Health Care Exchange. 2. Provide assistance to Medical Affairs, Clinical Development leadership, and Clinical Advisors in strategic projects (participate in cross functional teams, committee representation, etc.) as the subject matter expert in UM development. 3. Assist in training new or existing UM pharmacists on program revisions, enhancements and clinical positioning. Precept and/or mentor students and residents as requested. This is a hybrid role, based in-office 3 days/wk with the opportunity to work from home the remaining days. Candidate must reside in commutable distance to our Buffalo Grove, IL, Pittsburgh, PA, Woonsocket, RI, or Hartford, CT office locations. Required Qualifications BS in Pharmacy or PharmD Active, unrestricted pharmacist licensure 4+ years clinical pharmacist experience, to include UM experience 2+ years managed care (PBM) pharmacist experience, and/or completion of a PGY1 Managed Care residency Preferred Qualifications Clinical Pharmacy Practice Residency Education Bachelor Degree, Pharmacy (required) Doctorate Degree, Pharmacy (PharmD) (preferred) Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $118,000.00 - $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: 03/09/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area. Apply tot his job Apply To this Job