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Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

The supervisor is responsible for providing operational leadership and direction for Specialty Prior Authorization and Appeals business units. The position has a primary focus on ensuring compliance with all state, federal, and client regulations and accredidations. Other key areas of focus include coaching and mentoring CRU employees, including pharmacists and technicians; quality improvement; innovation and reduction of unit costs. Responsibilities of the position include daily operational oversight, staff development, budget management, audit readiness, staff training documentation and execution, and policy and procedure documentation. The leader will work with internal partners and the CRU staff to service physicians, pharmacists and patients within service level agreements.

• This position is a remote, work from home position, but candidate must reside in Hawaii.

Responsibilities

• Using the tools provided, monitor day-to-day staff/department activities and staff production to ensure department goals and SLAs are being met.

• Leading the Case Review Unit ensuring the operational unit is complying with regulatory requirements and accreditation standards.

• Participates in evaluation of clinical criteria used in prior authorization reviews

• Establishes and maintains communication amongst CVS Caremark’s departments, clients, and delegates.

• Participates in quality management activities on ongoing bases, including but not limited to work instructions, job aids, and quality monitoring.

• Uses clinical knowledge to handle escalated calls from physicians or patients regarding prior authorization clinical questions.

• Performs other related projects and duties as assigned.

Required Qualifications

• • Active pharmacist license in Hawaii, that is in good standing.

• 1+ years pharmacist experience in pharmacy education or prior authorization

• Previous supervisory experience

• Must be computer literate. Knowledge of Excel, Word and Power Point.

• 5 to 8 years prior work experience in related area or field.

• Knowledge of Access and Visio.

• Bachelor Degree in Pharmacy. Doctorate Degree in Pharmacy preferable.

Pay Range

The typical pay range for this role is:

$91,386.75 - $196,800.00

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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 03/11/2024

CVS Health requires certain colleagues 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, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.