Clinical Pharmacy Support Technician

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

A Brief Overview

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.

Position Summary

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. This will include outreach calls to providers, pharmacists, and members. Responsibilities also include 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 determines 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
• 4+ years’ work experience
• Responsible for making prescriber and or pharmacy outreach which includes reviewing formulary vs. non-formulary prescription claims.
• Ensure member is receiving the appropriate therapy as approved by the provider and determine length of therapy and establish if current claims are appropriate.
• Review therapeutic duplication data and contact providers and pharmacies to establish correct therapy for members.
• Responsible for prescriber outreach for specific Scoreable Action Item initiatives. Work with team Pharmacist to investigate specific cases of overutilization including potential member outreach to ensure member has received products that have been dispensed under plan.
• Maintain expert knowledge in most areas of pharmacy operations. Ability to analyze and interpret various types of complex claim data under member plans. Work with pharmacies to verify claims information and reverse unnecessary claims.
• Identify opportunities for improvement in departmental and pharmacy operations with recommendations for modes of resolution.
• Train, coach, and mentor new Clinical Support Technician Staff.

Work from Home: Monday - Friday

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

Required 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

Preferred Qualifications

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

Education

• High School Diploma or equivalent

Anticipated Weekly Hours

40

Time Type

Full time

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

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.