Clinical Analyst

Job DescriptionOur Clinical Health Plan sales analyst role is a great opportunity for an individual who has an interest in pharmacy and the managed care environment. The individual will work with data that will help the Clinical Account Services department provide the best service possible to clients. This role is going to work very closely with many of our Clinical Advisors who are aligned to our various Health Plan clients in order to provide assistance in the day to day management of the clinical service offerings we provide TheClinical Analyst will support many of the activities related to the services listed above including manipulating internal reporting tools to meet client reporting requirements. Some examples of the clinical service offerings we provide are: -Implementation of new clinical solutions -Utilization of formulary management tools -Analyzing physician and patient drug use data to identify patternsDuties include: Reporting and Operational Support Supports clinical advisors to help meet client reporting requirements Support clinical advisors on data needed to support Pharmacy &Therapeutics committees 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/deliverables and ensures data is accurate before sharing with clinical advisor Proactively suggest solutions and integrates best practices across accounts Researches and interprets claims data, plan coding, copay structure etc. Assists with clinical ad hoc mailings, running utilization queries and coordinating the mailings with Clinical Fulfillment Med D specific - upload and output formularies. Export change files, adjust tiering, add, change and remove medications. Customize member formulary documents.Required Qualifications- 3+ 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 RequirementsCOVID-19 Vaccination RequirementCVS 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.Preferred Qualifications- Pharmacy experience preferred- Strong Communication skills- Ability to work at a fast pace- Critical thinking skills- Strategic thinking skills- Ability to work in a team setting- Ability to demonstrate strong problem solving skills- Ability to work independently and effectively manage workloadEducationHigh School Diploma or GED required. Bachelor's degree preferred or equivalent experience.Business OverviewBring your heart to CVS HealthEvery 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. 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.

Created: 2025-11-15