Description

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

As a Clinical Formulary Strategy Pharmacist, you will play a key role in the assessment and execution of formulary strategy for the Commercial line of business.

What will you do:

Formulary Management & Oversight

• Formulary Oversight for all Fully Insured Business
• Collaborate with Utilization Management to develop and implement Prior Authorization Criteria specific to Aetna.

Cost of Care Initiatives

• Cross functional collaboration in the development, implementation, support, and tracking of Aetna Commercial pharmacy cost of care initiatives to meet financial goals.
• ROI development with pharmacy teams, measurement new initiatives
• May lead certain cost of care projects.

Fraud, Waste, and Abuse Identification

• Fraud, waste, & abuse (FWA) monitoring
• Collaboration with both Special Investigation Units on pharmacy FWA items

Product Support

• Collaborate with Product Teams to develop/enhance offerings to meet market demands.
• Responsible for Clinical Field Communications

Strategy and Continuous Improvement

• Responsible for end-to-end process of strategizing, development, and implementation for Pharmacy cost of care initiatives.
• Main clinical resource for the Health Plan for all issues/concerns that are pharmacy related.

This is a remote role open to qualified candidates within the United States, with the ideal candidate residing in the Eastern or Central time zones.

Required Qualifications

• Active, unrestricted pharmacist license
• 5+ years of demonstrated formulary or cost of care management pharmacist experience
• Highly organized, detail-oriented with strong capability in structured and critical thinking
• Demonstrated experience with FWA
• High level of independent judgment and proactivity
• Self-motivation, high energy, and ability to successfully function in a high-demand, performance-driven environment.
• Strong internal relationship skills across diverse teams

Preferred Qualifications

• Knowledge of Fully Insured health plans
• Works well in a dynamic, complex, customer and team-focused environment with minimal oversite and agile mindset.
• Ability to work in 100% virtual setting.

Education

• BS in Pharmacy or PharmD

Anticipated Weekly Hours
40

Time Type
Full time

Pay Range

The typical pay range for this role is:

$106,200.00 - $225,000.00

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: 12/17/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.