[Hiring] Clinical Pharmacy Support Technician @CVS Health

Role Description

Administers operational support to clinical pharmacy staff. Conducts outreach to providers, pharmacists, and members. Supports day-to-day processes, reviews data, and documents relevant interactions.

Primary responsibility is supporting Formulary Alternative Outreach Program for Medicare Part D. The Clinical Support Technician will support the operations of the Retro DUR (Drug Utilization Review)/Scorable Action Items (SAI) Clinical Pharmacy staff. Responsibilities include:

• Outreach calls to providers, pharmacists, and members.
• Managing day-to-day processes.
• Analyzing data.
• Organizing and documenting all relevant interactions.

Executes both routine and non-routine business support tasks for the Clinical Pharmacy Support area under limited supervision, referring deviations from standard practices to managers. Follows area protocols, standards, and policies to provide effective and timely support.

• Conducts reviews to ensure members receive the appropriate therapy as approved by the provider.
• Determines therapy timelines and claim appropriateness.
• Initiates education for providers and pharmacies on medication options, enhancements, and alternative therapy options for members.
• Communicates with pharmacies to verify claim information and reverse unnecessary claims.
• Ability to solve problems and make decisions independently.
• Responsible for making prescriber and/or pharmacy outreach, including reviewing formulary vs. non-formulary prescription claims.
• Ensures member is receiving the appropriate therapy as approved by the provider.
• Reviews therapeutic duplication data and contacts providers and pharmacies to establish correct therapy for members.
• Responsible for prescriber outreach for specific Scoreable Action Item initiatives.
• Works with team Pharmacist to investigate specific cases of overutilization.
• Maintains expert knowledge in most areas of pharmacy operations.
• Ability to analyze and interpret various types of complex claim data under member plans.
• Identifies opportunities for improvement in departmental and pharmacy operations with recommendations for modes of resolution.
• Trains, coaches, and mentors new Clinical Support Technician Staff.

Work from Home: Monday - Friday

Schedule: Monday - Friday, 8:00a - 5:00p local time

Qualifications

• 4 or more years’ relevant experience.
• Valid Pharmacy Technician Certification (PTCB or ExCPT).
• Working knowledge of Microsoft Outlook and Teams.
• Ability to interpret Pharmacy Claims data.
• Proficiency in computerized pharmacy systems and software applications.
• Previous provider/pharmacy outreach experience.
• Ability to perform duties with minimal supervision.
• Proficient knowledge of Brand/Generic drug names.

Requirements

• Managed Care experience.
• Advanced knowledge of Microsoft Office applications.
• Understanding of medical and pharmacy terminology.

Education

• High School Diploma or equivalent.

Benefits

• Comprehensive medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.

Pay Range

The typical pay range for this role is: $18.50 - $38.82. 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.

Application Information

We anticipate the application window for this opening will close on: 04/30/2026. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.