Clinical Requirement Analyst Carelon

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.

Position Summary

In this position, you will collaborate closely with multiple departments to ensure that client requests are executed accurately and efficiently. Additionally, you will be responsible for addressing any potential client configuration concerns that may arise. It is essential to demonstrate a high level of client service by ensuring accuracy, responsiveness, reliability, and professionalism in every interaction.

You will accomplish this by: 
• Forming relationships with key client partners through a consultative approach to fully understand clinical components of client benefit plan design
• Translating client requirements into operational formats for CVS Health teams such as Clinical Configuration, Quality Analysis and Testing
• Facilitating internal and external meetings and presentations to provide status updates and make decisions relative to client benefit setup

You will operate in a dynamic environment with tight deadlines, so the ability to operate autonomously and make decisions is imperative.

Required Qualifications

• 2 or more years of experience in account management, benefit plan design, or related client-facing field
• At least 2 years of experience in RxClaim/AS400 with a focus on formulary and utilization management preferred
• 5 + years of relevant work experience

Preferred Qualifications
• Experience working in Salesforce.com
• PBM Med D Industry Experience
• Clinical Understanding of Formulary and Utilization Management
• Demonstrated proficiency with Microsoft Excel

Education

• High School Diploma/GED
• Bachelor's degree preferred/specialized training/relevant professional qualification.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,300.00 - $132,600.00

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: 06/30/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.