At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary :
The Clinical Analyst role on the CVS Clinical Account Services team is a great opportunity for an individual with research and analytical interest to use their skills in a managed care pharmacy environment. The individual will, collect, analyze, and present clinical data. The individual will perform research and evaluate healthcare information from different sources to identify trends and business insights. The individual will utilize data tools to help the Clinical Advisors (Pharmacists) respond to data requests and support strategic clinical consultation to our client(s).
The Clinical Analyst will work with Clinical Advisors on data requests primarily to support our Government Business Unit. This will include analyzing client data requests, regulatory requests, benefit documents, utilization management edits (prior authorization, quantity limits, step therapy, etc.), HEDIS and quality information, operational data, and other clinical programs. The Clinical Analyst will conduct research and translate this information into the appropriate data request format, consult with account teams and client contacts to fully understand client request, and work with internal partners to ensure the pharmacy benefit data is accurately represented per the request specifications.
Responsibilities:
- Supports clinical advisors to help meet client reporting requirements
• Support clinical advisors on data needed to support Pharmacy & Therapeutics committee
• Support clinical advisors on data needed to support regulatory requests
• Supports clinical advisors to help communicate client formulary changes to internal partners
• Clarifies needs and suggests innovative ideas to meet client/clinical advisor requests
• Provides consultative analysis of results and suggests additional analysis, if appropriate
• Consistently performs quality checks on reports and ensures data is accurate before sharing with clinical advisor
• Supports special projects and work groups as needed to improve efficiencies and client satisfaction
• Proactively suggest solutions and integrates best practices across accounts
• Suggests and creates innovative solutions for improving existing process flows
• Assists with reporting and analysis to identify utilization and support clinical mailings
• Support custom formularies- upload and output formularies. Export change files, add, change, and remove medications. Customize member formulary documents
• Support new business bids with ad-hoc formulary and UM file pulls and compares, and clinical program reporting
• Leverages pre-built and self-built tools to support Clinical Advisor data manipulation and interpretation needs
• Special projects and work groups as needed to improve efficiencies and client satisfaction
• Design and develop customized qualitative and quantitative solutions to meet client needs
• Develop and implement mechanisms to automate tasks
• Work collaboratively with CVS Health clients during on-site or virtual meetings using a client-centered approach
• Provide guidance on spreadsheets, provide drug targeting associated with member mailings and grandfathering
• Utilize proprietary systems, reporting tools and software (RxNavigator, RxArchitect, iTools, Tableau, RxClaim, Salesforce etc.) to generate necessary client reporting and conduct research
Required Qualifications :
• 2 years of work experience in a health plan, PBM, Pharmacy, benefits, or insurance background
• 3 years of experience in Microsoft Office suite including proficient skills utilizing Outlook, Access, Word, Excel, and PowerPoint
COVID Vaccine Required :
Yes
COVID Requirements :
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
Preferred Qualifications :
• Not a licensed pharmacist position
• Pharmacy experience strongly preferred
• Pharmacy Technician certification
• Project Management Experience
• Specialization in one of the following: Medicare/Commercial/Exchange/Marketplace
• Ability to create macro enabled Access/Excel tools
• Experience using SQL or other language to create Access solutions
• 3+ years of experience in client/customer service-based environment
• Excellent organization, time management and multitasking skills (able to track and handle issues, ensure the right teams are engaged, facilitate comprehensive and timely issue resolution, etc.)
• Ability to work independently and effectively manage workload.
• Ability to pay attention to detail
• Ability to work in a fast-paced environment
• Strong analytical, and presentation skills
• Strong verbal and written communication skills
• Excellent knowledge of Prescription Benefit Management (PBM) industry preferred.
Education :
High School Diploma or GED required; Bachelor's degree preferred
Business Overview :
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$43,888.00 - $93,574.00This 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: 11/19/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.