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 Oncology/Medical Specialty Clinical Development Sr. Manager will be responsible for overseeing the development, maintenance, and execution of utilization management programs. This will include both the clinical content of the programs as well as the operational actions needed to ensure the programs are implemented correctly. Knowledge of utilization management interventions including prior authorization, step therapy, quantity limits, and Oncology and medical Specialty drug UM processes is required. The leader will feel comfortable partnering in a matrix relationship with colleagues at all levels and teams.
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, or New York, NY office locations.
Required Qualifications
- Licensed pharmacist in good standing in state of residence
- 5+ years pharmacist experience within PBM environment
- 3+ years demonstrated people leadership experience within PBM environment
-Board Certified Oncology Pharmacist (BCOP) or eligible for BCOP certification
- Demonstrated in-depth understanding of utilization management and formulary, including prior authorization, step therapy, quantity limits, and Oncology and medical Specialty drug UM processes is required
Demonstrated understanding of:
State and Federal governing rules and regulations.
In-depth understanding of Oncology and medical Specialty drugs specific to utilization management and formulary.
Skill In:
Managing teams within a matrixed environment
Partnering across multiple stakeholders and varied levels
Communication and presenting of strategies to Leadership
Excellent written and oral communication with proven ability to distill complex concepts to leaders, colleagues and peers
Office technology and software, including Rx Claim and Medispan
Demonstrated ability to:
manage multiple complex, ongoing projects
meet timelines for critical deliverables
manage direct reports to achieve team and enterprise goals
work cross-functionally while maintaining and improving inter-departmental relationships
Preferred Qualifications
PGY1 Managed Care Residency
5+ years people leadership experience
Education
Required - BS in Pharmacy or PharmD
Required - Current Pharmacist License in good standing
Pay Range
The typical pay range for this role is:
$128,750.00 - $239,250.00
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. This position also includes an award target in the company’s equity award program.
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: 12/26/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.