Aetna Veterans Jobs

Job Information

Aetna Clinical Pharmacy Manager in New York, New York

Req ID: 71661BR

Job Description

Clinical Pharmacy Managers develop and promote strategies and policies that enhance quality of pharmaceutical and medical pharmaceutical care in a cost effective manner to establish competitive business advantage for CVS Health and Aetna . Clinical Pharmacy Managers core responsibilities include the development, implementation, support and promotion of clinical policies and utilization management focused on pharmaceutical, medical pharmaceutical, gene and cellular therapies.

LICENSES AND CERTIFICATIONS (one of the two listed below)

Nursing/Registered Nurse (RN) is desired

Pharmacy/Registered Pharmacist (RPh)/PhD is desired

Fundamental Components included but are not limited to:

  • Develop CVS Enterprise clinical policy criteria and clinical UM management programs that optimize quality of patient care and healthcare costs

  • Implements national clinical management programs through CVS Enterprise clinical review process including Clinical Policy Oversight and Pharmacy & Therapeutics Committee for new to market pharmaceuticals, FDA label updates and Annual drug reviews.

  • Participates in External Consultant clinical reviews as appropriate

  • Collaborates, supports and promotes Enterprise Trade and Product programs and products

  • Proactively identifies opportunities for improvement within assigned initiatives

  • Champions strategic direction and tactical game plans for delivery of pharmaceutical care.

  • Directs and changes enhancements to business processes, policies, and infra-structure to improve operational efficiency.

Qualifications Requirements and Preferences:

3+ years administrative experience. In-depth knowledge and experience in Specialty Formulary/Clinical UM criteria management in managed care / managed pharmacy / competitive environment. A current, unrestricted clinical license(s) to practice is required. Degree in Pharmacy or Nursing; Business degree a plus. Medicare/Medicaid experience, Appeals experience a plus.

LICENSES AND CERTIFICATIONS (one of the two listed below)

Nursing/Registered Nurse (RN) is desired

Pharmacy/Registered Pharmacist (RPh)/PhD is desired

Benefit Eligibility

Benefit eligibility may vary by position.

Job Function: Healthcare

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.

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