Clinical Pharmacist:
Aetna Inc.

Aetna Inc.
Job Description

This position provides comprehensive management, facilitating the delivery of appropriate quality healthcare in evaluating, authorizing, and communicating prior authorization pharmacy requests according to clinical guidelines. Performs prospective and/or retrospective drug utilization review. Coordinates the distribution of clinical drug information and educates providers and staff regarding the appropriate use of pharmaceutical treatment regimens. Promotes cost effective outcomes and improve program/operational efficiency. This position is also accountable for participating in the development, implementation, and ongoing monitoring of program initiatives.

Primary Duties & Responsibilities:

1. Responsible for the clinical case management for the Specialty Program and high utilizers taking non-specialty medications.

2. First point of contact on established Prior Authorizations for members, local pharmacists, and prescribers.

3. Medical Management-working directly with nurse case managers and local physicians to manage medication related problems. Collaborates with other medical personnel in developing treatment guidelines and demonstrates the impact of these guidelines.

4. Research and data analysis leading to overall plan benefit assessment and recommendations for clinical and cost saving opportunities for the member and the plan. May participate in formulary development and management.

5. Medication Therapy Management for all members

6. Provides reporting on utilization trends as well as industry trends and opportunities.

7. Active participant of the following programs by providing clinical knowledge to the Team as well as case management to the participating members when necessary:

a. Medical Weight Loss Program

b. Pain Management Program

c. Bariatric Surgery Program

d. Behavioral Health Program

e. Diabetes Care Program

f. Sleep Apnea Program

g. Fitness and Weight Management Programs

h. General Wellness Programs

i. Cardiac Risk for Life Program

j. Co-Author of the Rx monthly publication

8. Active participant in the PBM Quarterly Review Meetings and Drug Review Committee

9. Provides guidance on drug supplies and new product availability.

10. Preceptor for Pharmacy Intern Program

Required Qualifications

Current unrestricted state license (FL)

Bachelor's degree or PharmD from an accredited school of Pharmacy

Ability to travel to office in Bradenton, FL

1-3 years of clinical pharmacy experience

COVID Requirements

COVID-19 Vaccination Requirement

CVS Health requires its Colleagues in certain positions 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, pregnancy, or religious belief that prevents them from being vaccinated.

* If you are 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 within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
* If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications

Managed care experience

Understanding of medical and pharmacy terminology

Knowledge of clinical program components, formulary designs, and prescription benefit trends


Bachelor's degree or PharmD from an accredited school of Pharmacy required

Business Overview

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.