Clinical Pharmacist – Prior Authorization

CVS Health

Clinical Pharmacist facilitating prior authorization requests for CVS Health. Collaborating with healthcare providers to ensure timely coverage determinations and effective communication with various stakeholders.

Posted 7/14/2026full-timeRemote • Texas • 🇺🇸 United StatesMid-LevelSenior💰 $50 - $85 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in prior authorization processes and clinical criteria evaluation, while maintaining effective communication with healthcare providers and team members. Possesses strong problem-solving skills and the ability to adapt to changing workflows in a fast-paced environment.

Highest-signal resume keywords

Active Pharmacist LicensurePrior Authorization ExperienceMicrosoft Office Suite ProficiencyProblem Solving AbilityCommunication Skills

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Prior Authorization ProcessingClinical Criteria EvaluationKeyboard SkillsMultitaskingResource Utilization

Soft Skills

Attention to DetailTeam CollaborationMentorshipAdaptabilityCustomer Communication

Tools & Technologies

Microsoft ExcelMicrosoft WordMicrosoft AccessMicrosoft OutlookMicrosoft PowerPointMicrosoft Visio

Certifications & Qualifications

Active Pharmacist Licensure

Industry Keywords

Protected Healthcare InformationCaremark PA OpsHealthcare ProvidersReferral ProcessingEmployer Group Staff

About the role

Key responsibilities & impact

Collaborates with the technicians and prior authorization team members to process referrals
Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design
Guarantee that decisions regarding cases are conveyed promptly and efficiently
Performs and handles inbound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients
Establishes and maintains communication among CVS Caremark, health plan, and employer group staff
Maintains professional and technical knowledge of drug and disease states
Performs other related projects and duties as assigned

Requirements

What you’ll need

Active, unrestricted pharmacist licensure
Current pharmacist experience within Caremark PA Ops required
Ability and willingness to work a flexible hourly schedule to include overtime, weekends, and holidays as needed
Knowledge of Microsoft Office Suite: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable
Keyboard skills essential
Must be able to multitask and utilize multiple system applications simultaneously
Must be able to utilize available resources independently and provide high quality work
Must demonstrate problem solving ability and attention to detail
Ability to adapt and change with workflow and shifting priorities
Ability to work effectively in a team environment and provide mentorship to non-clinical staff on the prior authorization team
Must possess excellent written, verbal, grammar, and listening communication skills
Must be able to effectively communicate with a diverse customer base (internal and external) in a friendly and confident manner
Ability to maintain confidentiality of PHI (Protected Healthcare Information)

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
other resources, based on eligibility