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RPh Operations Advisor - Med D

CVS Health

🌍 Anywhere 🏠 Remote ⏱ Full-time 💼 Mid-level 🗓 2 days ago

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 As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You will be responsible for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. This is a great opportunity to initiate a career with a leading healthcare company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience. Required Qualifications -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 -Demonstrated ability to utilize multiple software systems, simultaneously with a 2-screen workstation setup (Windows based operations, AS400, MHK, PeopleSafe, WI database, 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 -Must be able to review large volume of information, determine importance, and apply clinical knowledge to assist in outcome -Must be able to work independently and utilize critical thinking/problem solving skills to m...

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